MEDICARE: TIMOTHY MORGAN GEORGE NP-C

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	363LF0000X	Family Nurse Practitioner	98711	WV
2	363LF0000X	Family Nurse Practitioner	2301792	MA

General Provider Information

NPI Number	:	1932589959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY MORGAN GEORGE NP-C

Provider Business Mailing Address
First Line	:	912 SOMERSET BLVD STE 101
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3952
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	912 SOMERSET BLVD STE 101
Second Line	:
City	:	CHARLES TOWN
State	:	WV
Zip	:	25414-3952
Country	:	US
Telephone Number	:	304-725-2663
Fax Number	:	304-724-0053

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

Provider Enumeration Date	:	06/04/2015
Last Update Date	:	01/11/2023

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