Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 010196841 | VA |
N | 208600000X | Surgeon | 010196841 | VA |
Y | 208200000X | Surgeon | MD463261 | PA |
Y | 208600000X | Surgeon | MD463261 | PA |
NPI | 1013934538 |
---|---|
Provider Name | Dr. Timothy Justin Germain |
First Address | Erie, PA 16502-4609 |
Second Address | Erie, PA 16502-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 02/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010196841 | (05) | VA |
H87961 | (02) | VA |