Provider Demographics
NPI:1194809566
Name:MADGAR, TIMOTHY F (OD PA)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:F
Last Name:MADGAR
Suffix:
Gender:M
Credentials:OD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7954 HARFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5838
Mailing Address - Country:US
Mailing Address - Phone:410-665-5353
Mailing Address - Fax:410-665-9703
Practice Address - Street 1:7954 HARFORD ROAD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5838
Practice Address - Country:US
Practice Address - Phone:410-665-5353
Practice Address - Fax:410-665-9703
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA0865152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDX222TFOtherCARE FIRST
T59935Medicare UPIN
X222Medicare ID - Type Unspecified
MD4928680001Medicare NSC