Individual
DR. TIMOTHY R FENGLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2435 FOREST DR, COLUMBIA, SC 29204-2026
(803) 865-4780
(803) 865-4932
Mailing address
PO BOX 601964, CHARLOTTE, NC 28260-1964
(855) 477-2477
(216) 472-2740
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
14325
SC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
14325
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
14325
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050028870
RR MEDICARE
SC
01
—
143295
SELECT HEALTH
SC
05
—
143295
—
SC
01
—
2001059
CCP
SC
01
—
4130017
AETNA
SC
01
—
77791
MEDCOST
SC
Enumeration date
10/15/2006
Last updated
09/17/2014
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