Terry Scott Baul, M.D., P.C.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301042171 Issued in MI

Legal business name

TERRY SCOTT BAUL, M.D., P.C.

Practice address

17751 E Warren Ave
Detroit, MI 48224-1329

Phone

(313) 885-6833

Fax

(313) 885-1268

NPI assigned

Jun 7, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Terry Scott Baul, D.O.

Title

Owner

Phone

(313) 885-6833

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1619238490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17751 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241329",
            "telephone_number": "313-885-6833",
            "fax_number": "313-885-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17751 E WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482241329",
            "telephone_number": "313-885-6833",
            "fax_number": "313-885-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRY SCOTT BAUL, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-07",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "BAUL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-885-6833",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301042171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0821263",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624055",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mellonie Gloria Terrell
• Ny'Dea Terrell
• Tammy Latice Terrell, LMSW
• Carlos Eduardo Terres
• Terry Adult Foster Care Inc.
• Alexis J Terry, LLPC
• Ashlynn Terry
• Charles A. Terry
• Robin Ricardo Terry, BS SWSST
• Sonya Anne Terry, CPRM-DP

• General Practice Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.