Individual
TIMOTHY ALAN FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1101 CUMBERLAND XING # 262, VALPARAISO, IN 46383-2356
(219) 299-4643
(219) 267-1720
Mailing address
1101 CUMBERLAND XING # 262, VALPARAISO, IN 46383-2356
(305) 725-2524
(317) 564-8399
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001158A
IN
213E00000X
Podiatrist
07001158B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201166760
—
IN
01
—
P01563138
RAILROAD MEDICARE
IN
Enumeration date
05/03/2010
Last updated
04/03/2017
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