Provider Demographics
NPI:1639171820
Name:HOOD, TERRY W (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:W
Last Name:HOOD
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 1:1560 BEAM AVE
Mailing Address - Street 2:STE D
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55109-1171
Mailing Address - Country:US
Mailing Address - Phone:651-748-1461
Mailing Address - Fax:651-777-1191
Practice Address - Street 1:2855 CAMPUS DR
Practice Address - Street 2:STE 570
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2660
Practice Address - Country:US
Practice Address - Phone:763-553-2073
Practice Address - Fax:763-553-2705
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23340207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FMA79619Medicare UPIN