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Individual

MR. TIMOTHY D SEMPLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
25500 POINT LOOKOUT RD, LEONARDTOWN, MD 20650
(301) 475-6204
(301) 997-6507
Mailing address
25500 POINT LOOKOUT RD, BOX 527, LEONARDTOWN, MD 20650
(301) 475-6204
(301) 997-6507

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
28119695
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
R143440
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
206403100
MD
01
430051192
MEDICARE RAILROAD
MD
Enumeration date
02/07/2006
Last updated
11/06/2009
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