Individual
DR. TIMOTHY JEREMIAH HORGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-5529
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0102205143
VA
208000000X
Pediatrics Physician
34.014111
OH
208000000X
Pediatrics Physician
Primary
LL37687
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0376803
—
OH
Enumeration date
06/16/2015
Last updated
08/29/2022
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