1669466819 NPI number — DR. CHRISTOPHER TIMBERLAKE ALEMAN MD

Table of content: DR. CHRISTOPHER TIMBERLAKE ALEMAN MD (NPI 1669466819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669466819 NPI number — DR. CHRISTOPHER TIMBERLAKE ALEMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEMAN
Provider First Name:
CHRISTOPHER
Provider Middle Name:
TIMBERLAKE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669466819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 CONCOURSE BLVD STE 190
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN ALLEN
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23059-5759
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-549-4030
Provider Business Mailing Address Fax Number:
804-549-4032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10710 MIDLOTHIAN TPKE STE 401
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RICHMOND
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23235-4723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
804-794-2307
Provider Business Practice Location Address Fax Number:
804-794-2944
Provider Enumeration Date:
09/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  25MA07469100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0300312 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2108371 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 070013772 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 197349 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 5901545 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2183149 . This is a "AETNA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 98070 . This is a "SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".




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