Individual
TIMOTHY VAYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
900 ILLINOIS AVE, STEVENS POINT, WI 54481-3114
(715) 346-5000
Mailing address
900 ILLINOIS AVE, STEVENS POINT, WI 54481-3114
(715) 346-5000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
56278
WI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
5101014334
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
56278
WI STATE LIC
WI
Enumeration date
07/04/2006
Last updated
04/25/2024
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