Provider Demographics
NPI:1851493951
Name:TIMINS, BRUCE IRA (MD)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:IRA
Last Name:TIMINS
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 NEWMARKET SQ
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-2721
Mailing Address - Country:US
Mailing Address - Phone:757-825-8030
Mailing Address - Fax:757-847-9149
Practice Address - Street 1:48 NEWMARKET SQ
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23605-2721
Practice Address - Country:US
Practice Address - Phone:757-825-8030
Practice Address - Fax:757-847-9149
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36915207RC0000X
NMMD2010-0552207RC0000X
VA0101263854207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK3148Medicare ID - Type Unspecified
FL066515100Medicaid
FL262397800Medicaid
95639AOtherBLUE CROSS
D63550Medicare UPIN
FL95639Medicare ID - Type UnspecifiedINDIVIDUAL
030119OtherAVMED
019273OtherHEALTH OPTIONS