Individual
TIMOTHY BRUCE SORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 N MAIN ST, DAYTON, OH 45415
(937) 279-5803
(937) 279-5803
Mailing address
725 UNIVERSITY BLVD, BEAVERCREEK, OH 45324-2640
(937) 245-7150
(866) 527-1320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301511126
MI
207RI0200X
Infectious Disease Physician
Primary
35053064
OH
207RI0200X
Infectious Disease Physician
4301511126
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0833674
—
OH
Enumeration date
10/18/2005
Last updated
06/18/2024
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