Provider Demographics
NPI:1285605386
Name:MACMATH, TERRY LEE (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:LEE
Last Name:MACMATH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3000 SAINT MATTHEWS RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-1442
Mailing Address - Country:US
Mailing Address - Phone:803-347-1472
Mailing Address - Fax:803-395-2065
Practice Address - Street 1:3000 SAINT MATTHEWS RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118
Practice Address - Country:US
Practice Address - Phone:803-347-1472
Practice Address - Fax:803-395-2065
Is Sole Proprietor?:No
Enumeration Date:2006-01-28
Last Update Date:2018-07-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME34676207P00000X, 207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD52645Medicare UPIN