Provider Demographics
NPI:1417070897
Name:MCINNIS, TERRY ALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:ALICE
Last Name:MCINNIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 FRENCHMANS BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-5661
Mailing Address - Country:US
Mailing Address - Phone:864-918-9998
Mailing Address - Fax:
Practice Address - Street 1:203 FRENCHMANS BLUFF DR
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-5661
Practice Address - Country:US
Practice Address - Phone:864-918-9998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC99000682083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine