Individual
MR. TIMOTHY A POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101049447
VA
207R00000X
Internal Medicine Physician
2017-00518
NC
208000000X
Pediatrics Physician
Primary
2017-00518
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010254558
—
VA
05
—
1699879924
—
NC
01
—
19RGP
BCBS OF NC
NC
01
—
461276
ANTHEM
VA
01
—
NCX793022
MEDICARE
NC
Enumeration date
09/08/2006
Last updated
02/28/2024
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