Provider Demographics
NPI:1235189762
Name:TIMMIS, STEVEN BH (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BH
Last Name:TIMMIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27901 WOODWARD AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-0919
Mailing Address - Country:US
Mailing Address - Phone:248-545-0070
Mailing Address - Fax:248-545-4850
Practice Address - Street 1:16800 W 12 MILE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-2108
Practice Address - Country:US
Practice Address - Phone:248-569-9797
Practice Address - Fax:248-569-9780
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2020-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301057715174400000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No174400000XOther Service ProvidersSpecialist
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4133551Medicaid
MI4133551Medicaid
MIG48493Medicare UPIN
MI0F36239Medicare PIN