MEDICARE: TIMOTHY HARRY TROEH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD00033501	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326046400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY HARRY TROEH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 87
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-0022
Country	:	US
Telephone Number	:	360-538-0135
Fax Number	:	360-533-3475

Provider Business Practice Location Address
First Line	:	1921 SUMNER AVENUE
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-1001
Country	:	US
Telephone Number	:	360-538-0135
Fax Number	:	360-533-3475

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	08/01/2014

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