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Contact Information

A NEDRA Y FULLER TERRY, DPM
2828 FIRST AVENUE
SUITE 203
HUNTINGTON, WV25702-1236
 Phone: 304-522-3692
 Fax: 304-522-3693
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for A NEDRA Y FULLER TERRY · (Female)

NPI # 1902976863
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 11/08/2006
Last updated 11/19/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • WV License # 10387
  • OH Medicaid 2707084
  • WV Medicaid 3810007238
  • WV Other P00357027 RR MEDICARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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