Healthcare Provider Details
I. General information
NPI: 1316173982
Provider Name (Legal Business Name): TIMOTHY DEIMLING M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/09/2009
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2025 TECHNOLOGY PKWY STE 108
MECHANICSBURG PA
17050-9401
US
IV. Provider business mailing address
2025 TECHNOLOGY PKWY STE 108
MECHANICSBURG PA
17050-9401
US
V. Phone/Fax
- Phone: 717-988-8170
- Fax: 717-221-5398
- Phone: 717-988-8170
- Fax: 717-221-5398
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MD447738 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: