Individual
TIMOTHY M AXE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
906-025
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619932621
—
WI
05
—
43239200
—
WI
01
—
60436
DEAN HEALTH INSURANCE
WI
Enumeration date
04/20/2006
Last updated
10/28/2020
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