Provider Demographics
NPI:1679565634
Name:TERRY, RICHARD FRANKLIN SR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:FRANKLIN
Last Name:TERRY
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 PARK VIEW LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-5493
Mailing Address - Country:US
Mailing Address - Phone:304-242-4700
Mailing Address - Fax:304-242-7012
Practice Address - Street 1:111 PARK VIEW LN
Practice Address - Street 2:SUITE 202
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-5493
Practice Address - Country:US
Practice Address - Phone:304-242-4700
Practice Address - Fax:304-242-7012
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2010-01-29
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Provider Licenses
StateLicense IDTaxonomies
WV9894207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
000009233OtherMOUNTAIN STATE BCBS
OH0391124OtherOHIO MEDICAID
WV0082552000Medicaid
WV0082552000Medicaid
WV0448295Medicare PIN