Individual
DR. TIMOTHY W WESTLAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
791 E SUMMIT AVE, OCONOMOWOC, WI 53066-3844
(262) 569-0251
(262) 569-0342
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41233-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32580800
—
WI
Enumeration date
12/19/2005
Last updated
12/21/2020
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