Provider Demographics
NPI:1255308516
Name:PIEPER, TERRY LEE (MD)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:LEE
Last Name:PIEPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 N HOWE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-2770
Mailing Address - Country:US
Mailing Address - Phone:910-457-4368
Mailing Address - Fax:910-457-0807
Practice Address - Street 1:1513 N HOWE ST STE 6
Practice Address - Street 2:
Practice Address - City:SOUTHPORT
Practice Address - State:NC
Practice Address - Zip Code:28461-2770
Practice Address - Country:US
Practice Address - Phone:910-457-4368
Practice Address - Fax:910-457-0807
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200001244207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00160260OtherRAILROAD MEDICARE
NC013UEOtherBCBS
H66636Medicare UPIN
2002725AMedicare PIN
2002725AMedicare ID - Type Unspecified