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Individual

TIMOTHY M WESTGATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O. D.

Contact information

Practice address
1301 BRIDGEVILLE HWY, SEAFORD, DE 19973-1616
(302) 629-9197
(302) 629-3335
Mailing address
885 S GOVERNORS AVE, DOVER, DE 19904-4158
(302) 734-5861
(302) 734-1921

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
130001190
DE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000214822
DE
01
000A74H16
MEDICARE PTAN
01
11220847
CAQH
01
1245251313
MEDICARE GROUP NPI
01
G00016
MEDICARE GROUP PIN
01
I3-0001190
LICENSE
DE
Enumeration date
02/17/2006
Last updated
02/27/2018
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