Provider Demographics
NPI:1114011947
Name:SCHAROLD, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:SCHAROLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22768
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29925-2768
Mailing Address - Country:US
Mailing Address - Phone:843-681-9300
Mailing Address - Fax:843-815-5650
Practice Address - Street 1:1 MALLETT WAY
Practice Address - Street 2:SUITE 101
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910
Practice Address - Country:US
Practice Address - Phone:843-681-9300
Practice Address - Fax:843-815-5650
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26494207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC264948Medicaid
SCE61006Medicare UPIN
SC264948Medicaid