Provider Demographics
NPI:1053996736
Name:DOFFLEMYER, TIMOTHY BRETT
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:BRETT
Last Name:DOFFLEMYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7345 STONELEIGH CT
Mailing Address - Street 2:
Mailing Address - City:HUGHESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20637-2145
Mailing Address - Country:US
Mailing Address - Phone:301-659-7706
Mailing Address - Fax:
Practice Address - Street 1:7345 STONELEIGH CT
Practice Address - Street 2:
Practice Address - City:HUGHESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20637-2145
Practice Address - Country:US
Practice Address - Phone:301-659-7706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-14
Last Update Date:2021-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer