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General NPI Number Information
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NPI Number | 1073556452
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Entity Type | Individual
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Provider Name | TIMOTHY JAMES DURKAN GREGORY MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 06/07/2024
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Provider Practice Location Address
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Address Line | 2060 CHARLIE HALL BLVD STE A
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City | CHARLESTON
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State | SC
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Zip | 29414-6066
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Country | US
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Telephone | 843-483-0193
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Fax | 843-213-4599
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Provider Business Mailing Address
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Address Line | PO BOX R
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City | POOLER
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State | GA
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Zip | 31322-0939
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Country | US
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Telephone | 912-232-9700
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Fax | 839-213-4599
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 33129
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License Number State | SC
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