Provider Demographics
NPI:1992921316
Name:HALTERMAN, TIMOTHY ERIC (MD)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:ERIC
Last Name:HALTERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 SPOTTED HORSE RD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4316
Mailing Address - Country:US
Mailing Address - Phone:614-579-4422
Mailing Address - Fax:
Practice Address - Street 1:10619 PROFESSIONAL CIR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-5831
Practice Address - Country:US
Practice Address - Phone:775-852-4848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13814207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology