Individual
TIMOTHY B. SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
LEE ST FL 3, CHARLOTTESVILLE, VA 22908-0001
(434) 243-6361
(434) 243-6280
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101040226
VA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
0101040226
VA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
036-126666
IL
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
0101040226
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005638623
—
VA
01
—
080141641
MEDICARE PIN
VA
01
—
142901
SOUTHERN HEALTH
VA
01
—
234064
ANTHEM SVC/HEALTHKEEPERS
VA
01
—
267138
MAMSI
VA
01
—
45187
COMMUNITY HEALTH
VA
05
—
45187
—
VA
01
—
700010935
CIGNA
VA
01
—
P00212563
MEDICARE PIN
VA
Enumeration date
01/24/2006
Last updated
09/12/2014
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