Podesta, Timothy Allen

Podesta, Timothy Allen is an sole proprietor health care provider with primary practice located at 200 Industrial Blvd , Dublin GA 31021-2981. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Podesta, Timothy Allen can be contacted via phone (478) 274-2000.

Contact Information

Primary practice address
200 Industrial Blvd Dublin GA 31021-2981
Phone: (478) 274-2000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 86347 Georgia

Profile Details

NPI number 1871024802
LBN Legal business name Podesta, Timothy Allen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2017
Last updated Mar 16th, 2021 - about 5 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 1871024802 NPPES
Georgia MEDICAID 003242899A
Georgia MEDICAID 003242899B
Georgia MEDICAID 003242899C

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