Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT015063 | PA |
NPI | 1033110135 |
---|---|
Provider Name | Mr. Timothy Michael Earman |
First Address | Grove City, PA 16127-1004 |
Second Address | Grove City, PA 16127-1004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 30/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
EA1363148 | BLUE CROSS BLUE SHIELD (01) | PA |