Provider Demographics
NPI:1609854793
Name:CHERWIN, TERRENCE J (DO)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:J
Last Name:CHERWIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E MUNDY ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-5154
Mailing Address - Country:US
Mailing Address - Phone:989-892-0099
Mailing Address - Fax:989-892-6514
Practice Address - Street 1:204 E MUNDY ST
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-5154
Practice Address - Country:US
Practice Address - Phone:989-892-0099
Practice Address - Fax:989-892-6514
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-09
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI009174207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1757490Medicaid
MI2050900195OtherBLUE CROSS AND BLUE SHIEL
5090019Medicare ID - Type Unspecified
E26807Medicare UPIN