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General NPI Number Information
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NPI Number | 1669464111
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Entity Type | Individual
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Provider Name | TIMOTHY BEITTEL MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 10/10/2011
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Provider Practice Location Address
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Address Line | 311-4E JUDGES RD
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City | WILMINGTON
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State | NC
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Zip | 28405
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Country | US
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Telephone | 910-791-6767
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Fax | 910-791-6890
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Provider Business Mailing Address
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Address Line | 311-4E JUDGES ROAD
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City | WILMINGTON
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State | NC
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Zip | 28405-3655
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Country | US
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Telephone | 910-791-6767
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Fax | 910-791-6890
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9900167
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License Number State | NC
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