Healthcare Provider Details

I. General information

NPI: 1306890082
Provider Name (Legal Business Name): BARBARA TYMKIW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY SUITE 310
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

712 TIMBER TREE PL SUITE 310
CROWNSVILLE MD
21032-1532
US

V. Phone/Fax

Practice location:
  • Phone: 410-573-9450
  • Fax: 410-573-9439
Mailing address:
  • Phone: 410-573-9450
  • Fax: 410-573-9439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0038148
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberDOO38148
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: