Doctor Name: | DR. TERRELL MORGAN BOND |
NPI Number: | 1336177583 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01042638A |
Business Practice Address: | 1717 S Calhoun St Fort Wayne, IN - 468025257 |
Business Phone Number: | 2604582641 |
Business Fax Number: | 2604582574 |
Mailing Address: | 1717 S Calhoun St, FORT WAYNE |
State: | IN |
Postal Code: | 468025257 |
Phone Number: | 2604582641 |
Fax Number: | 2604582574 |
NPI Enumeration Date: | 06/28/2006 |
NPI Last Update Date: | 02/25/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 01042638A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |