Provider Demographics
NPI:1518313311
Name:ANGELL, TERRY
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:
Last Name:ANGELL
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 1:100 E CARROLL ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5422
Mailing Address - Country:US
Mailing Address - Phone:800-749-5191
Mailing Address - Fax:
Practice Address - Street 1:106 MILFORD ST STE 605
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-6938
Practice Address - Country:US
Practice Address - Phone:800-749-5191
Practice Address - Fax:410-630-7685
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG0000928363LF0000X
MDAC001802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily