Provider Demographics
NPI:1730340225
Name:TIMMERMAN, DANIEL S (DO)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:S
Last Name:TIMMERMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:134 BRIDGETON PIKE
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2616
Mailing Address - Country:US
Mailing Address - Phone:856-507-2783
Mailing Address - Fax:856-221-4138
Practice Address - Street 1:525 STATE ST STE 6
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-2164
Practice Address - Country:US
Practice Address - Phone:856-279-2842
Practice Address - Fax:856-279-2848
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-00710207Q00000X, 208600000X
NJ25MB09695600208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2401671AMedicare PIN