Idiaghe, Timothy

Idiaghe, Timothy is an individual health care provider with primary practice located at 129 N Washington St , Sumter SC 29150. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Idiaghe, Timothy can be contacted via phone (803) 774-9680.

Contact Information

Primary practice address
129 N Washington St Sumter SC 29150
Phone: (803) 774-9680
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301089530 Michigan
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 31331 South Carolina

Profile Details

NPI number 1437362456
LBN Legal business name Idiaghe, Timothy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Dec 10th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437362456 NPPES
South Carolina MEDICAID 313315

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