Provider Demographics
NPI:1417050410
Name:QUINT, TIMOTHY STEVEN (DC)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:STEVEN
Last Name:QUINT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3822 OLEANDER DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-6715
Mailing Address - Country:US
Mailing Address - Phone:910-392-8896
Mailing Address - Fax:910-392-8628
Practice Address - Street 1:3822 OLEANDER DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-6715
Practice Address - Country:US
Practice Address - Phone:910-392-8896
Practice Address - Fax:910-392-8628
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3231111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC661759OtherACN
NC085PGOtherBLUECROSS BLUESHIELD
NC89085PGMedicaid
NC89085PGMedicaid