Physician Compare National (NPI:1508186784)

HEALTHCARE PROVIDER: TIMOTHY MICHAEL ERWIN MD PHD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1508186784
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3072756345
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160621001355
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ERWIN
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	MICHAEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NEW MEXICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ZIA DIAGNOSTIC IMAGING
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4284710369
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4701 MONTGOMERY BLVD NE
	Group Practice or individual's line 1 address
Line 2 Street Address	LOVELACE WOMEN'S HOSPITAL (LLWH)
	Group Practice or individual's line 2 address
City	ALBUQUERQUE
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	871031219
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5057277800
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	320017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LOVELACE WOMEN'S HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	320074
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LOVELACE WESTSIDE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	320009
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	LOVELACE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y