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Individual
TIMOTHY T WELLEMEYER
Active
Individual
TIMOTHY T WELLEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
TW044920
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100235
PHYSICIANS HEALTH PLAN OF
MI
01
—
0170235
PHYSICIANS HEALTH PLAN OF
MI
05
—
102805476
—
MI
01
—
TW044920
BCBSM
—
Enumeration date
05/03/2006
Last updated
12/16/2013
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