Healthcare Provider Details

I. General information

NPI: 1699870683
Provider Name (Legal Business Name): TIMOTHY P DAALEMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

143 W FRANKLIN ST
CHAPEL HILL NC
27516-2539
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-4131
  • Fax:
Mailing address:
  • Phone: 919-966-4131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200200340
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: