Shaver, Timothy Roddy

Shaver, Timothy Roddy is an individual health care provider with primary practice located at 1860 Town Center Dr Ste 440 , Reston VA 20190-5908. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Shaver, Timothy Roddy can be contacted via phone (571) 554-8950.

Contact Information

Primary practice address
1860 Town Center Dr Ste 440 Reston VA 20190-5908
Phone: (571) 554-8950
Fax: (571) 554-8951
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 0101049305 Virginia

Profile Details

NPI number 1417950981
LBN Legal business name Shaver, Timothy Roddy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Mar 17th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417950981 NPPES
District of Columbia MEDICAID 051838700
District of Columbia MEDICAID 010068096

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