Provider Demographics
NPI:1861491771
Name:HUNTER, TIMOTHY M (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:M
Last Name:HUNTER
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 1:287 HIGHWAY 90 E STE 6
Mailing Address - Street 2:
Mailing Address - City:LITTLE RIVER
Mailing Address - State:SC
Mailing Address - Zip Code:29566-7214
Mailing Address - Country:US
Mailing Address - Phone:843-492-5009
Mailing Address - Fax:843-492-5012
Practice Address - Street 1:287 HIGHWAY 90 E STE 6
Practice Address - Street 2:
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-7214
Practice Address - Country:US
Practice Address - Phone:843-492-5009
Practice Address - Fax:843-492-5012
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19026207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT26004Medicaid
SCF589714639Medicare PIN
SCD589714639Medicare PIN
SCT26004Medicaid