Provider Demographics
NPI:1972000297
Name:HERBERG, TIMOTHY JOSHUA (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:JOSHUA
Last Name:HERBERG
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:PO BOX 2727
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20195-0727
Mailing Address - Country:US
Mailing Address - Phone:703-471-0919
Mailing Address - Fax:
Practice Address - Street 1:24440 STONE SPRINGS BLVD
Practice Address - Street 2:
Practice Address - City:DULLES
Practice Address - State:VA
Practice Address - Zip Code:20166-2247
Practice Address - Country:US
Practice Address - Phone:703-471-0919
Practice Address - Fax:703-742-9081
Is Sole Proprietor?:No
Enumeration Date:2018-04-12
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101278220207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology