Doctor Name: | DR. TIMOTHY G MORIARTY |
NPI Number: | 1578539805 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME0061983 |
Business Practice Address: | 221 E 23rd St Suite B Panama City, FL - 324057612 |
Business Phone Number: | 8508720502 |
Business Fax Number: | 8508720677 |
Mailing Address: | Po Box 9560, PANAMA CITY BCH |
State: | FL |
Postal Code: | 32417 |
Phone Number: | 8508720502 |
Fax Number: | 8508720677 |
NPI Enumeration Date: | 02/27/2006 |
NPI Last Update Date: | 02/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME0061983 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |