Timothy J Shambaugh in Fort Wayne - Oral And Maxillofacial Surgery
Timothy J Shambaugh - NPI 1124038260
Timothy J Shambaugh is a Oral And Maxillofacial Surgery in Fort Wayne, Indiana. Timothy J Shambaugh practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Timothy J Shambaugh is 1124038260. The last update date is 2008-07-01.
Timothy J Shambaugh's current location address is 4606 D East State Blvd, Fort Wayne, Indiana. You can contact this provider via phone number 2604232340 and fax number 2604225342. The mailing address for Timothy J Shambaugh is 4606 D East State Blvd, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
Provider Name | Timothy J Shambaugh |
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Address | 4606 D East State Blvd, Fort Wayne, Indiana |
Phone Number | 2604232340 |
Fax Number | 2604225342 |
Sole Proprietor | N |
Credentials | DDS |
NPI Number Detail
NPI Number | 1124038260 |
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Provider Enumeration Date | 2006-08-09 |
Last Updated Date | 2008-07-01 |
Provider Mailing Address Detail
Address | 4606 D East State Blvd |
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City | Fort Wayne |
State | Indiana (IN) |
Post Code | 468156963 |
Phone Number | 2604232340 |
Fax Number | 2604225342 |
Provider's Primary Taxonomy Detail
Speciality | Oral And Maxillofacial Surgery |
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Taxonomy | 1223S0112X |
Licence No | 127177 |
Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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200029030 | IN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Timothy J Shambaugh by the Centers for Medicare & Medicaid Services (CMS)?
The Timothy J Shambaugh has been assigned the NPI (National Provider Identifier) 1124038260. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you share the physical location details of Timothy J Shambaugh?
The Timothy J Shambaugh is situated at 4606 D East State Blvd, in the city of Fort Wayne, state of IN, with the zip code 468156963.
What is the Timothy J Shambaugh's specialty and taxonomy code?
The Timothy J Shambaugh's specialty is Oral And Maxillofacial Surgery, and the corresponding taxonomy code is 1223S0112X.
On what date did Timothy J Shambaugh receive its 1124038260 assignment from the Centers for Medicare & Medicaid Services?
The Timothy J Shambaugh was assigned its 1124038260 on 2006-08-09, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information regarding Timothy J Shambaugh most recently updated?
The details pertaining to the Timothy J Shambaugh, including its address, specialty, and other relevant information, were last refreshed on 2008-07-01.
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