Individual
DR. TIMOTHY IDIAGHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 320, COLUMBIA, SC 29203-6896
(803) 434-6771
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301089530
MI
207R00000X
Internal Medicine Physician
Primary
31331
SC
208M00000X
Hospitalist Physician
31331
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313315
—
SC
Enumeration date
05/07/2007
Last updated
06/13/2025
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