Healthcare Provider Details

I. General information

NPI: 1407151681
Provider Name (Legal Business Name): MARGARET ELIZABETH TIMM PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARGARET ELIZABETH CARTER PA-C

II. Dates (important events)

Enumeration Date: 01/19/2011
Last Update Date: 01/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 LOWER DALLAS HWY
DALLAS NC
28034-9368
US

IV. Provider business mailing address

824 LOWER DALLAS HWY
DALLAS NC
28034-9368
US

V. Phone/Fax

Practice location:
  • Phone: 704-874-0200
  • Fax:
Mailing address:
  • Phone: 704-874-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0010-02660
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: