Provider Demographics
NPI:1669770699
Name:TIMBO, CARLA ANN
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ANN
Last Name:TIMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19320 CIRCLE GATE DR
Mailing Address - Street 2:APT 204
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5230
Mailing Address - Country:US
Mailing Address - Phone:240-440-1041
Mailing Address - Fax:
Practice Address - Street 1:19320 CIRCLE GATE DR
Practice Address - Street 2:APT 204
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5230
Practice Address - Country:US
Practice Address - Phone:240-440-1041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy