Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01012340193 | VA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D59857 | MD |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD34115 | DC |
NPI | 1043358922 |
---|---|
Provider Name | Dr. Timothy James Egan |
First Address | Potomac, MD 20854-2625 |
Second Address | Annandale, VA 22003-1275 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86226 | (02) |