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Individual
DR. TIMOTHY RAYMOND NIEDZIELAK
Active
Individual
DR. TIMOTHY RAYMOND NIEDZIELAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036165587
IL
207X00000X
Orthopaedic Surgery Physician
2022018519
MO
207X00000X
Orthopaedic Surgery Physician
5665
FL
207XX0801X
Orthopaedic Trauma Physician
2022018519
MO
390200000X
Student in an Organized Health Care Education/Training Program
5665
FL
Other
Enumeration date
08/06/2017
Last updated
09/12/2023
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