Individual
TIMOTHY R WASSENAAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106
(262) 696-5690
Mailing address
N16W24131 RIVERWOOD DR, WAUKESHA, WI 53188-1106
(262) 696-5690
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46327
WI
207RH0003X
Hematology & Oncology Physician
Primary
46327
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34691700
—
WI
Enumeration date
03/28/2006
Last updated
01/10/2024
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