MEDICARE: ROBERT E TIMBERLAKE JR. M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	37158	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	P00928650	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	0009445	OTHER	AETNA
2	491323	OTHER	US FAMILY HEALTH PLAN
3	037158	OTHER	TUFTS
4	6064	OTHER	HPHC
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	TIC05109	OTHER	BCBS

General Provider Information

NPI Number	:	1437153061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT E TIMBERLAKE JR. M.D.

Provider Business Mailing Address
First Line	:	147 COURT STREET
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360
Country	:	US
Telephone Number	:	508-746-6710
Fax Number	:	508-830-1117

Provider Business Practice Location Address
First Line	:	147 COURT STREET
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360
Country	:	US
Telephone Number	:	508-746-6710
Fax Number	:	508-830-1117

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	09/12/2008

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