Individual
TIMOTHY J OMARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8316 TRAFORD LN, SPRINGFIELD, VA 22152
(703) 569-8400
(703) 569-1182
Mailing address
8316 TRAFORD LN, SPRINGFIELD, VA 22152
(703) 569-8400
(703) 569-1182
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101229984
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101229984
MEDICAL LICENSE #
VA
01
—
11486963
CAQH
—
01
—
1205349
UNITED HEALTHCARE
—
01
—
3980135
AETNA HMO
—
01
—
7473712
AETNA POS PPO
—
01
—
8139211
MAMSI OPTIMUM CHOICE MD I
—
01
—
B9390010
CARE FIRST BCBS
—
Enumeration date
10/26/2006
Last updated
07/08/2007
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