Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD432774 | PA |
N | 208600000X | Surgeon | MD432774 | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD432774 | PA |
NPI | 1134399801 |
---|---|
Provider Name | Dr. Timothy Scott Misselbeck |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Allentown, PA 18103-6224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 25/11/2015 |