Individual
DR. TIMOTHY ALLEN PODESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 INDUSTRIAL BLVD, DUBLIN, GA 31021-2981
(478) 274-2000
Mailing address
200 INDUSTRIAL BLVD, DUBLIN, GA 31021-2997
(478) 751-0181
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
86347
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003242899A
—
GA
05
—
003242899B
—
GA
05
—
003242899C
—
GA
Enumeration date
03/22/2017
Last updated
03/16/2021
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