Basic Information
Provider Information
NPI: 1992913735
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHIZMAR
FirstName: TIMOTHY
MiddleName: PAUL
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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Mailing Information
Address1: 110 S PACA ST
Address2: 6TH FLOOR, SUITE 200
City: BALTIMORE
State: MD
PostalCode: 212011642
CountryCode: US
TelephoneNumber: 4103288025
FaxNumber: 4103288028
Practice Location
Address1: 500 UPPER CHESAPEAKE DR
Address2: EMERGENCY DEPARTMENT
City: BEL AIR
State: MD
PostalCode: 210144324
CountryCode: US
TelephoneNumber: 4436432110
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/17/2007
LastUpdateDate: 09/27/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000XD0069864MDY Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


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