Provider Demographics
NPI:1659381440
Name:ZELLER, TIMOTHY AARON (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:AARON
Last Name:ZELLER
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 1:200 BOOKER DR
Mailing Address - Street 2:
Mailing Address - City:WALHALLA
Mailing Address - State:SC
Mailing Address - Zip Code:29691-2278
Mailing Address - Country:US
Mailing Address - Phone:864-656-3076
Mailing Address - Fax:
Practice Address - Street 1:200 BOOKER DR
Practice Address - Street 2:
Practice Address - City:WALHALLA
Practice Address - State:SC
Practice Address - Zip Code:29691-2278
Practice Address - Country:US
Practice Address - Phone:864-656-3076
Practice Address - Fax:864-885-7749
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28852208M00000X, 207Q00000X
NC2024-00432208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC288521Medicaid
SCAA9837Medicare PIN