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Individual
TIMOTHY ALAN FITZGERALD
Active
Individual
TIMOTHY ALAN FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001158A
IN
213E00000X
Podiatrist
07001158B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201166760
—
IN
01
—
P01563138
RAILROAD MEDICARE
IN
Enumeration date
05/03/2010
Last updated
04/03/2017
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