Grady, Timothy P
Grady, Timothy P is an individual health care provider with primary practice located at 500 Wind Ridge Dr , Wausau WI 54401-4173. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Grady, Timothy P can be contacted via phone (715) 847-2611.Contact Information
Primary practice address
500 Wind Ridge Dr
Wausau WI 54401-4173
Phone: (715) 847-2611
Fax: (715) 847-2465
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 39273 | Wisconsin |
Profile Details
| NPI number | 1386644409 |
|---|---|
| LBN Legal business name | Grady, Timothy P |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 29th, 2005 |
| Last updated | Jan 17th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386644409 | NPPES |
| Wisconsin | MEDICAID | 30084400 |
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