Individual
TIMOTHY F WETHERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1631 HOSPITAL DR, SUITE 240, SANTA FE, NM 87505-4728
(505) 913-3975
(505) 986-8001
Mailing address
1631 HOSPITAL DR, SUITE 240, SANTA FE, NM 87505-4728
(505) 913-3975
(505) 986-8001
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD2005-0088
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10020619
LOVELACE
—
01
—
202007841
PRESBYTERIAN HEALTH PLAN
—
01
—
2523396
UHC
—
05
—
98708881
—
NM
01
—
NM001H25
BCBS NM
NM
01
—
QMYPR0069821
MOLINA HEALTHCARE
—
Enumeration date
06/07/2006
Last updated
08/12/2010
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