Provider Demographics
NPI:1265540702
Name:PURMAN, TIMOTHY GARRETT (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:GARRETT
Last Name:PURMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:T.
Other - Middle Name:GARRETT
Other - Last Name:PURMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:120 N BRIDGE ST STE D
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-8823
Mailing Address - Country:US
Mailing Address - Phone:810-287-4643
Mailing Address - Fax:810-458-4634
Practice Address - Street 1:120 N BRIDGE ST STE D
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:MI
Practice Address - Zip Code:48451-8823
Practice Address - Country:US
Practice Address - Phone:810-287-4643
Practice Address - Fax:810-458-4634
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072286208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0000Medicare UPIN