Provider Demographics
NPI:1922080159
Name:O'DONOVAN, TERRENCE M (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:M
Last Name:O'DONOVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:200 HOSPITAL DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-5884
Mailing Address - Country:US
Mailing Address - Phone:410-768-5555
Mailing Address - Fax:410-768-5835
Practice Address - Street 1:200 HOSPITAL DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5884
Practice Address - Country:US
Practice Address - Phone:410-768-5555
Practice Address - Fax:410-768-5835
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0046166207X00000X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH828Medicare ID - Type Unspecified
B97903Medicare UPIN