Healthcare Provider Details

I. General information

NPI: 1528000775
Provider Name (Legal Business Name): TIMOTHY P DESMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 05/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

534 BILTMORE AVE
ASHEVILLE NC
28801-4612
US

IV. Provider business mailing address

PO BOX 2679
ASHEVILLE NC
28802-2679
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-0801
  • Fax:
Mailing address:
  • Phone: 828-253-3322
  • Fax: 828-253-1895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number31481
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: