Individual
DR. TIMOTHY ROSS DIESTELKAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4302 E WHITTON AVE, PHOENIX, AZ 85018-5944
(251) 680-6451
Mailing address
4302 E WHITTON AVE, PHOENIX, AZ 85018-5944
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
72505
AZ
Other
Enumeration date
04/02/2018
Last updated
04/29/2024
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