Provider Demographics
NPI:1285690024
Name:DREHMER, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:DREHMER
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 1:998 S DORSET RD STE 301
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-4748
Mailing Address - Country:US
Mailing Address - Phone:937-339-9865
Mailing Address - Fax:937-339-6668
Practice Address - Street 1:31 S STANFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2334
Practice Address - Country:US
Practice Address - Phone:937-332-0306
Practice Address - Fax:937-440-7243
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-21
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35072748207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2021430Medicaid
OH2021430Medicaid
DR0836341Medicare ID - Type Unspecified