Provider Demographics
NPI:1619963337
Name:TERZIAN, JOHN K (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:K
Last Name:TERZIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:711 W CENTER ST
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1542
Mailing Address - Country:US
Mailing Address - Phone:508-583-1100
Mailing Address - Fax:508-583-1120
Practice Address - Street 1:711 W CENTER ST
Practice Address - Street 2:SUITE 2100
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1542
Practice Address - Country:US
Practice Address - Phone:508-583-1100
Practice Address - Fax:508-583-1120
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-27
Last Update Date:2010-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA52785207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
A58723Medicare UPIN