Provider Demographics
NPI:1538546585
Name:TERRELL, MARY JEANNE (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JEANNE
Last Name:TERRELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JEANNE
Other - Last Name:LUSKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:UNC DEPARTMENT OF PEDIATRICS UNC SOM
Mailing Address - Street 2:260 MACNIDER BUILDING, CB#7220
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7220
Mailing Address - Country:US
Mailing Address - Phone:919-966-1505
Mailing Address - Fax:919-966-7299
Practice Address - Street 1:UNC DEPARTMENT OF PEDIATRICS UNC SOM
Practice Address - Street 2:260 MACNIDER BUILDING, CB#7220
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7220
Practice Address - Country:US
Practice Address - Phone:919-966-1505
Practice Address - Fax:919-966-7299
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-29
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-002852080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine