Individual provider · Type 1 NPI
Timothy James Mineo, D.P.M.
Foot & Ankle Surgery Podiatrist · Gresham, OR
NPI number
1275730459
Active
Practice location
24076 SE Stark St, Suite 110
Gresham, OR 97030-3373
Mailing address
16890 SW Ledgestone Dr
Beaverton, OR 97007-5189
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | DP151976 (OR) |
Foot & Ankle Surgery Podiatrist: Definition to come...
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About NPI 1275730459
Timothy James Mineo, D.P.M.'s National Provider Identifier is 1275730459, issued on Jun 29, 2007. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Gresham, OR. The record was last updated on Aug 8, 2013.