Provider Demographics
NPI:1386671683
Name:TERPLAN, MISHKA S (MD)
Entity Type:Individual
Prefix:DR
First Name:MISHKA
Middle Name:S
Last Name:TERPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 PARK AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5633
Mailing Address - Country:US
Mailing Address - Phone:410-837-3977
Mailing Address - Fax:
Practice Address - Street 1:1040 PARK AVE STE 103
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5633
Practice Address - Country:US
Practice Address - Phone:410-837-3977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00697262083A0300X
VA0101261470207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2036357Medicare ID - Type Unspecified
NC2036357Medicaid
NCI23597Medicare UPIN