Provider Demographics
NPI:1710943410
Name:MARSH, TERRY WESTON (MD)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:WESTON
Last Name:MARSH
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 1:401 W MCGALLIARD RD
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47303-1828
Mailing Address - Country:US
Mailing Address - Phone:765-288-6200
Mailing Address - Fax:765-288-4131
Practice Address - Street 1:401 W MCGALLIARD RD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-1828
Practice Address - Country:US
Practice Address - Phone:765-288-6200
Practice Address - Fax:765-288-4131
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031077A207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology