Provider Demographics
NPI:1518012806
Name:MUIR, TIMOTHY DAVID (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:DAVID
Last Name:MUIR
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 1:500 W ANNANDALE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-4205
Mailing Address - Country:US
Mailing Address - Phone:703-521-6662
Mailing Address - Fax:703-521-5991
Practice Address - Street 1:500 W ANNANDALE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-4205
Practice Address - Country:US
Practice Address - Phone:703-521-6662
Practice Address - Fax:703-521-5991
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101226093207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H16692Medicare UPIN
VA000X95P86Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER