Most Relevant Information
Provider Data
| NPI Number: | 1003358573 |
| Provider Name: | TIMOTHY ANDREW WIENKE |
| Entity Type: | Individual |
| Taxonomy Code: | 1710I1002X |
| Specialty: | Military Health Care Provider |
| License Number: |
Most Important Dates
| Enumeration Date: | 11/15/2016 |
| Last Updated: | 11/15/2016 |
Provider Practice Location
3399 STRAUSS AVE
INDIAN HEAD
MD
206405164
Practice Location Phone/Fax
| Phone: | 3017442038 |
| Fax: |
Provider Mailing Location
3934 SCANLAND RD
INDIAN HEAD
MD
206404425
Provider Mailing Phone/Fax
| Phone: | 6613171255 |
| Fax: |