Individual
DR. TIMOTHY ALLEN PODESTA
Active
Individual
DR. TIMOTHY ALLEN PODESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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