Provider Demographics
NPI:1518231000
Name:GRETEN, TIM F (MD)
Entity Type:Individual
Prefix:
First Name:TIM
Middle Name:F
Last Name:GRETEN
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:NCI BUILDING 10 RM 12N226
Mailing Address - Street 2:10 CENTER DRIVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-4723
Mailing Address - Fax:
Practice Address - Street 1:NCI BUILDING 10 RM 12N226
Practice Address - Street 2:10 CENTER DRIVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0048405207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology