Healthcare Provider Details

I. General information

NPI: 1992987853
Provider Name (Legal Business Name): TIMOTHY STYLES MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1887 POWHATAN ST NAVAL ENV. & PREV. MED. UNIT 2
NORFOLK VA
23511-3319
US

IV. Provider business mailing address

1887 POWHATAN ST NAVAL ENV. & PREV. MED. UNIT 2
NORFOLK VA
23511-3319
US

V. Phone/Fax

Practice location:
  • Phone: 757-953-6588
  • Fax:
Mailing address:
  • Phone: 757-953-6588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number01055080A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: