Individual
MARK G TIMMERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
(608) 588-7724
Mailing address
436 SUNRISE DR, SPRING GREEN, WI 53588-9286
(608) 588-2502
(608) 588-7724
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
31402-020
WI
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
31402-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31648300
—
WI
01
—
P00463755
RAILROAD MEDICARE
WI
Enumeration date
05/23/2006
Last updated
04/29/2008
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