Individual
MR. TIMOTHY KLUSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.A.
Contact information
Practice address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
(414) 358-5421
Mailing address
4025 N 92ND ST, WAUWATOSA, WI 53222-1613
(414) 358-5431
(414) 358-5421
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
2014031836
MO
367H00000X
Anesthesiologist Assistant
Primary
49-017
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124429022
—
WI
Enumeration date
09/10/2014
Last updated
07/21/2022
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