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NPI Code Detail

MEDICARE: DR. TIMOTHY M WIRTH M.D.

MEDICARE: DR. TIMOTHY M WIRTH 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
1207R00000XInternal Medicine PhysicianMD031593EPA

Other Identifiers

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

General Provider Information

NPI Number : 1396741765
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY M WIRTH M.D.
Provider Business Mailing Address
First Line : PO BOX 13579
Second Line :
City : READING
State : PA
Zip : 19612-3579
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3200 READING CREST AVE
Second Line :
City : READING
State : PA
Zip : 19605-1656
Country : US
Telephone Number : 610-816-2120
Fax Number : 610-929-5138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 04/11/2018

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