Healthcare Provider Details

I. General information

NPI: 1699759472
Provider Name (Legal Business Name): TIMOTHY A BIEREMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 PLUM CREEK CT
OAKLAND MI
48363-2153
US

IV. Provider business mailing address

2560 PLUM CREEK CT
OAKLAND MI
48363-2153
US

V. Phone/Fax

Practice location:
  • Phone: 248-761-8782
  • Fax:
Mailing address:
  • Phone: 248-761-8782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number4301404762
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: