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Individual
DR. TIMOTHY T LANTVIT
Active
Individual
DR. TIMOTHY T LANTVIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004656
IL
213E00000X
Podiatrist
07000775
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002219563
BCBS
IL
05
—
016004656
—
IL
01
—
0732240001
DMERC # WITH PPG
—
05
—
1720134422
—
IA
05
—
200136470A
—
IN
01
—
480017047
RAILRAOD MEDICARE
IL
01
—
P01770673
RAILROAD MEDICARE
IA
Enumeration date
01/26/2007
Last updated
01/22/2019
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