| Doctor Name: | MR. TERRENCE JOHN HEIDENREITER |
| NPI Number: | 1346230125 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RNC |
| License Number: | R152573 |
| Business Practice Address: | 2480 Llewellyn Ave Red Team Ft Meade, MD - 207555800 |
| Business Phone Number: | 3016778949 |
| Business Fax Number: | 3016778499 |
| Mailing Address: | 2480 Llewellyn Ave, Attn: Mcxr-cr Kimbrough Ambulatory Care Center FT MEADE |
| State: | MD |
| Postal Code: | 207555800 |
| Phone Number: | 3016778270 |
| Fax Number: | 3016778176 |
| NPI Enumeration Date: | 10/24/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | R152573 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |