Provider Demographics
NPI:1922160787
Name:ADIN L TIMBAYAN MD INC
Entity Type:Organization
Organization Name:ADIN L TIMBAYAN MD INC
Other - Org Name:FAMILY MEDICAL & SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:TIMBAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-442-4204
Mailing Address - Street 1:PO BOX 299
Mailing Address - Street 2:411 WASHINGTON ST
Mailing Address - City:MONTGOMERY
Mailing Address - State:WV
Mailing Address - Zip Code:25136
Mailing Address - Country:US
Mailing Address - Phone:304-442-4204
Mailing Address - Fax:304-442-4204
Practice Address - Street 1:411 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:WV
Practice Address - Zip Code:25136
Practice Address - Country:US
Practice Address - Phone:304-442-4204
Practice Address - Fax:304-442-4204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty