Provider Demographics
NPI:1104448646
Name:SPARROW, TERRY V
Entity type:Individual
Prefix:MR
First Name:TERRY
Middle Name:V
Last Name:SPARROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6923 COLDSTREAM CT
Mailing Address - Street 2:
Mailing Address - City:BRYANS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616-6100
Mailing Address - Country:US
Mailing Address - Phone:202-280-0189
Mailing Address - Fax:
Practice Address - Street 1:3005 BLADENSBURG RD NE APT 221
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-2239
Practice Address - Country:US
Practice Address - Phone:202-288-1196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant