Ter Poorten, Maryanna C

Ter Poorten, Maryanna C is an individual health care provider with primary practice located at 335 Penny Ln , Concord NC 28025-1221. She recently has only one registered license in Allopathic & Osteopathic Physicians / Procedural Dermatology, which is considered as her primary health care specialty. Ter Poorten, Maryanna C can be contacted via phone (704) 784-5901.

Contact Information

Primary practice address
335 Penny Ln Concord NC 28025-1221
Phone: (704) 784-5901
Fax: (704) 721-0413
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 2003-00893 North Carolina

Profile Details

NPI number 1477539724
LBN Legal business name Ter Poorten, Maryanna C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2005
Last updated Feb 12th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477539724 NPPES
North Carolina MEDICAID 89134VK
North Carolina Other P00232695

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