Provider Demographics
NPI:1154701951
Name:TERRY, MERRYL JANE (MD)
Entity type:Individual
Prefix:DR
First Name:MERRYL
Middle Name:JANE
Last Name:TERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:505 PARNASSUS AVE RM M551
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2204
Mailing Address - Country:US
Mailing Address - Phone:415-476-5236
Mailing Address - Fax:
Practice Address - Street 1:505 PARNASSUS AVE RM M551
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2204
Practice Address - Country:US
Practice Address - Phone:415-476-5236
Practice Address - Fax:415-476-7963
Is Sole Proprietor?:No
Enumeration Date:2015-06-05
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-09003207W00000X
CA177758207ZN0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZN0500XAllopathic & Osteopathic PhysiciansPathologyNeuropathology
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology