Provider Demographics
NPI:1821382391
Name:TIMOTHY A PRICE MD PC
Entity type:Organization
Organization Name:TIMOTHY A PRICE MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-463-0220
Mailing Address - Street 1:1330 NEW HAMPSHIRE AVE NW
Mailing Address - Street 2:SUITE 121
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6350
Mailing Address - Country:US
Mailing Address - Phone:202-463-0220
Mailing Address - Fax:202-463-0222
Practice Address - Street 1:1330 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:SUITE 121
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6350
Practice Address - Country:US
Practice Address - Phone:202-463-0220
Practice Address - Fax:202-463-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD17748174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC185895Medicare UPIN