Individual
TIMOTHY LEE DERSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
340 MEDICAL PKWY, STE 200, GREER, SC 29650-2441
(864) 797-9400
(864) 797-9402
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
31261
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312619
—
SC
01
—
P00656863
RAILROAD MEDICARE
SC
Enumeration date
02/08/2006
Last updated
01/26/2018
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