Provider Demographics
NPI:1609899764
Name:LAYMAN, TERRY L (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:L
Last Name:LAYMAN
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 1:11501 CUMBERLAND RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7010
Mailing Address - Country:US
Mailing Address - Phone:317-621-9393
Mailing Address - Fax:317-621-9383
Practice Address - Street 1:11501 CUMBERLAND RD
Practice Address - Street 2:SUITE 500
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7010
Practice Address - Country:US
Practice Address - Phone:317-621-9393
Practice Address - Fax:317-621-9383
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047170A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP00286744OtherRR MEDICARE
IN000000329171OtherANTHEM
INP01027054OtherRR MEDICARE
IN214600AMedicare PIN
ING99962Medicare UPIN
INP00286744OtherRR MEDICARE