Individual
TIMOTHY BRIAN CUMMINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1260 UPPER HEMBREE ROAD, SUITE C, ROSWELL, GA 30076
(678) 356-0484
(678) 356-0480
Mailing address
1260 UPPER HEMBREE ROAD, SUITE C, ROSWELL, GA 30076
(678) 356-0484
(678) 356-0480
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
GA041100
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D1004401
CLIA
—
01
—
GRP4985
MEDICARE GROUP
—
Enumeration date
08/01/2006
Last updated
04/14/2011
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