Provider Demographics
NPI:1962445718
Name:TERRY, AISHA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:
Last Name:TERRY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2120 L ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1527
Mailing Address - Country:US
Mailing Address - Phone:202-741-2911
Mailing Address - Fax:
Practice Address - Street 1:900 23RD ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2342
Practice Address - Country:US
Practice Address - Phone:202-741-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0064451207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD451601000Medicaid
MD381221900Medicaid
MD410645800Medicaid
MD381221900Medicaid
MDS2919Medicare PIN
MDH254Medicare ID - Type UnspecifiedMEDICARE GRP #
MD613LO371Medicare PIN
MD410645800Medicaid