Individual
MR. TIMOTHY W LONGBINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2525 COURT DRIVE, GASTONIA, NC 28054
(704) 834-2000
Mailing address
PO BOX 12845, GASTONIA, NC 28052
(704) 834-2825
(704) 866-7853
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
9601382
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133R3
BC
NC
01
—
2277202B
MEDICARE
NC
05
—
8912274
—
NC
05
—
N01382
—
SC
Enumeration date
07/11/2006
Last updated
11/29/2018
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