Individual
DR. TIMOTHY DWAYNE THUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1811 CHARLTON CT, GOSHEN, IN 46526-6464
(574) 534-8200
(574) 534-0411
Mailing address
1104 S 7TH ST, GOSHEN, IN 46526-4304
(574) 533-9945
(574) 534-0411
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01025799
IN
Other
Enumeration date
08/05/2006
Last updated
07/08/2007
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