Individual
TIMOTHY S PAVEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1726 SHAWANO AVE, GREEN BAY, WI 54303-3216
(920) 498-4200
(920) 884-4829
Mailing address
111 E WISCONSIN AVE, SUITE 2000, MILWAUKEE, WI 53202-4815
(414) 290-6720
(414) 290-6755
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28571-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31628500
—
WI
05
—
433154910
—
MI
01
—
930108288
MEDICARE RAILROAD
WI
01
—
930108289
MEDICARE RAILROAD
WI
Enumeration date
07/04/2006
Last updated
12/27/2021
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