Provider Demographics
NPI:1144230012
Name:WESTBLOM, TORE ULF (MD)
Entity Type:Individual
Prefix:DR
First Name:TORE
Middle Name:ULF
Last Name:WESTBLOM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1901 S 1ST ST
Mailing Address - Street 2:INFECTIOUS DISEASES (111-INF)
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-7451
Mailing Address - Country:US
Mailing Address - Phone:254-743-0885
Mailing Address - Fax:254-743-0026
Practice Address - Street 1:1901 S 1ST ST
Practice Address - Street 2:INFECTIOUS DISEASES (111-INF)
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-7451
Practice Address - Country:US
Practice Address - Phone:254-743-0885
Practice Address - Fax:254-743-0026
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO36529207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease