Provider Demographics
NPI:1679592836
Name:TERRASSA, MARGARITA (MD)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:TERRASSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 KRESGE WAY STE 30
Mailing Address - Street 2:ATT JOANIE MARTIN
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4680
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 KRESGE WAY STE 30
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4680
Practice Address - Country:US
Practice Address - Phone:502-891-8712
Practice Address - Fax:502-891-8746
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY39695207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY50007570OtherPASSPORT PCP
KY000000370863OtherANTHEM
KY50007572OtherPASSPORT SPECIALITY
KY50007571OtherPASSPORT SPECIALITY
KY000000370869OtherANTHEM
KY64102981Medicaid
IN200543340Medicaid
KY0722529Medicare PIN
KY1275799Medicare PIN
KY000000370863OtherANTHEM