Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 25042 | WV |
N | 207RG0100X | Gastroenterologist | MD032895E | PA |
N | 207RG0100X | Gastroenterologist | ME151443 | FL |
NPI | 1023017530 |
---|---|
Provider Name | Dr. Timothy Orphanides |
First Address | Martinsburg, WV 25401-9000 |
Second Address | Martinsburg, WV 25401-9003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 26/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012965350001 | (05) | PA |
111445000 | (05) | FL |
13269 | AETNA (01) | PA |
187526 | PA BLUE SHIELD (01) | PA |
3810024307 | (05) | WV |
B40901 | (02) | PA |
N7309 | FL HF MEDICARE (01) | FL |
WV1814A | MEDICARE PTAN (01) | WV |