Provider Demographics
NPI:1164497822
Name:TERC, GREGORIO ENRIQUE (MD)
Entity Type:Individual
Prefix:
First Name:GREGORIO
Middle Name:ENRIQUE
Last Name:TERC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10670
Mailing Address - Street 2:2340 AVE EDUARDO RUBERTE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00732-0670
Mailing Address - Country:US
Mailing Address - Phone:787-844-6980
Mailing Address - Fax:787-844-6980
Practice Address - Street 1:CARIBE BUILDING
Practice Address - Street 2:2053 PONCE BY PASS, SUITE 202
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-1308
Practice Address - Country:US
Practice Address - Phone:787-844-6980
Practice Address - Fax:787-651-6717
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR5136207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
27062Medicare ID - Type Unspecified
D08389Medicare UPIN