Wallace, Timothy M
Wallace, Timothy M is an individual health care provider with primary practice located at 36500 Aurora Dr , Summit WI 53066-4899. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Wallace, Timothy M can be contacted via phone (262) 434-3741.Contact Information
Primary practice address
36500 Aurora Dr
Summit WI 53066-4899
Phone: (262) 434-3741
Fax: (262) 434-3702
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 41030 | Wisconsin |
Profile Details
| NPI number | 1720013121 |
|---|---|
| LBN Legal business name | Wallace, Timothy M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Dec 30th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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