Individual
TIMOTHY VELLINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUITE 200, SUMMIT, WI 53066-4899
(262) 434-5000
(262) 434-7350
Mailing address
4101 INDIAN SCHOOL RD NE, STE 110, ALBUQUERQUE, NM 87110-3991
(262) 434-5000
(262) 434-7350
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
25473
WI
207RI0011X
Interventional Cardiology Physician
Primary
MD2014-0940
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30716800
—
WI
Enumeration date
03/24/2006
Last updated
06/02/2019
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