Provider Demographics
NPI:1679685226
Name:PIPER, TERRENCE L (MD)
Entity Type:Individual
Prefix:
First Name:TERRENCE
Middle Name:L
Last Name:PIPER
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:PO BOX 790379
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63179-0379
Mailing Address - Country:US
Mailing Address - Phone:636-229-5900
Mailing Address - Fax:636-229-5011
Practice Address - Street 1:112 PIPER HILL DR
Practice Address - Street 2:SUITE 6
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1690
Practice Address - Country:US
Practice Address - Phone:636-229-5900
Practice Address - Fax:636-229-5011
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMD35542207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000004710Medicare ID - Type UnspecifiedMEDICARE ID
MOMA1395002Medicare PIN
MOA25958Medicare UPIN