Individual
TIMOTHY VANEVERY
Active
Individual
TIMOTHY VANEVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
TV039837
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1802400101
BLUE CROSS BLUE SHIELD
MI
01
—
7000020101
PRIORITY HEALTH
MI
Enumeration date
08/10/2006
Last updated
07/08/2007
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