Provider Demographics
NPI:1568489425
Name:HAGEMANN, TIMOTHY WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:WAYNE
Last Name:HAGEMANN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8001 FRANKLIN FARMS DR
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-5108
Mailing Address - Country:US
Mailing Address - Phone:804-521-5800
Mailing Address - Fax:804-545-4340
Practice Address - Street 1:7505 RIGHT FLANK RD
Practice Address - Street 2:SUITE 700
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-3865
Practice Address - Country:US
Practice Address - Phone:804-559-0405
Practice Address - Fax:804-559-0409
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2020-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101047653207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110928OtherANTHEM/VA HEALTHKEEPERS
VA111019OtherANTHEM/VA HEALTHKEEPERS
VA27413300OtherFEDERAL BLACK LUNG
VA276272OtherANTHEM/VA HEALTHKEEPERS
VA44222OtherSENTARA HEALTH/OPTIMA
VA500515OtherAETNA/US HEALTHCARE HMO
VA110913OtherANTHEM/VA HEALTHKEEPERS
VA417755OtherMAMSI
VA60035367OtherRAILROAD MEDICARE
VA110922OtherANTHEM/VA HEALTHKEEPERS
VA276354OtherANTHEM/VA HEALTHKEEPERS
VA103860OtherANTHEM/VA HEALTHKEEPERS
VA1413328OtherCIGNA
VA4246878OtherAETNA/US HEALTHCARE
VA6078923Medicaid
VA56370OtherSOUTHERN HEALTH SERVICES
VA25-00128OtherUNITED HEALTHCARE
VA25-00128OtherUNITED HEALTHCARE
VA500515OtherAETNA/US HEALTHCARE HMO