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Individual
TIMOTHEA SERIATOS
Active
Individual
TIMOTHEA SERIATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD064293L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01398102
CAPITAL BLUE CROSS
PA
05
—
1020453540001
—
PA
01
—
21120
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/29/2006
Last updated
11/16/2022
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