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Individual

DR. TIMOTHY R DILLINGHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3400 SPRUCE STREET, 1 GROUND WHITE BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3261
Mailing address
3400 SPRUCE STREET, 1 GROUND WHITE BUILDING, PHILADELPHIA, PA 19104-4206
(215) 662-3261

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
45568
WI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD444452
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
004806261N
HUMANA
05
34362900
WI
Enumeration date
05/13/2006
Last updated
12/02/2011
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