Provider Demographics
NPI:1457336083
Name:NEVILLE, TERRY DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:DEAN
Last Name:NEVILLE
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 1:9475 LOTTSFORD RD
Mailing Address - Street 2:STE 250
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5346
Mailing Address - Country:US
Mailing Address - Phone:301-636-6504
Mailing Address - Fax:301-636-6509
Practice Address - Street 1:2480 LLEWELLYN AVE STE 5800
Practice Address - Street 2:
Practice Address - City:FORT GEORGE G MEADE
Practice Address - State:MD
Practice Address - Zip Code:20755-5129
Practice Address - Country:US
Practice Address - Phone:301-677-8895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD49012084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry