Provider Demographics
NPI:1144488586
Name:KOLB, TERENCE W (MD)
Entity type:Individual
Prefix:DR
First Name:TERENCE
Middle Name:W
Last Name:KOLB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2855 OLD HIGHWAY 5
Mailing Address - Street 2:NORTH
Mailing Address - City:BLUE RIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30513-6248
Mailing Address - Country:US
Mailing Address - Phone:706-632-3711
Mailing Address - Fax:
Practice Address - Street 1:2855 OLD HIGHWAY 5
Practice Address - Street 2:NORTH
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513
Practice Address - Country:US
Practice Address - Phone:706-632-3711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-31
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC149276207P00000X
GA070146207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine