Provider Demographics
NPI:1518227727
Name:ATEM, TERENCE A
Entity Type:Individual
Prefix:
First Name:TERENCE
Middle Name:A
Last Name:ATEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 RIVERDALE RD
Mailing Address - Street 2:#302
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3937
Mailing Address - Country:US
Mailing Address - Phone:240-533-1810
Mailing Address - Fax:
Practice Address - Street 1:7777 RIVERDALE RD
Practice Address - Street 2:#302
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3937
Practice Address - Country:US
Practice Address - Phone:240-533-1810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA350789018113374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide