Provider Demographics
NPI:1902435373
Name:WARREN, TIMOTHY W (DO)
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:W
Last Name:WARREN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:7 DOCK HILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLEBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17842-8910
Mailing Address - Country:US
Mailing Address - Phone:570-837-2123
Mailing Address - Fax:570-837-2185
Practice Address - Street 1:300 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMMELSTOWN
Practice Address - State:PA
Practice Address - Zip Code:17036-1725
Practice Address - Country:US
Practice Address - Phone:717-566-1100
Practice Address - Fax:717-566-0600
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS021581207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine