Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy C Petersen, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1639468887

Timothy C Petersen, MD is an Endocrinology in Va Beach, Virginia. Graduated from Eastern Virginia Medical School in 2011, 15 years ago. Practices with Tidewater Physicians Multispecialty Group, PC, a 269-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Virginia.

Years since qualifying
15
Trained at
Eastern Virginia Medical School
Licensed in
VA
In the registry since
2011
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

100 Constitution Dr Ste 217
Va Beach, VA 23462-6799
Phone: (757) 963-1488
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endocrinology, Diabetes & Metabolism Physician (primary) Taxonomy 207RE0101X · Licence 0101260679 (VA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1639468887
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 28, 2011
Last updated in NPPESJune 30, 2016
Mailing address860 Omni Blvd, Ste 303, Newport News, VA 23606-4434

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyENDOCRINOLOGY
Medical schoolEASTERN VIRGINIA MEDICAL SCHOOL
Graduated 2011 (15 years in practice)
Group practice Tidewater Physicians Multispecialty Group, Pc — 269 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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