Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 91-329 | NM |
NPI | 1023024510 |
---|---|
Provider Name | Thomas Craig Timm |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Albuquerque, NM 87106-2745 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 01/05/2012 |