Provider Demographics
NPI:1932257094
Name:OELTMANN, TIMOTHY RENFREW (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RENFREW
Last Name:OELTMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MAG-39
Mailing Address - Street 2:MEDICAL
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-0000
Mailing Address - Country:US
Mailing Address - Phone:760-725-2969
Mailing Address - Fax:
Practice Address - Street 1:MARINE AIRCRAFT GROUP 39
Practice Address - Street 2:MEDICAL
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-365-2969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL271192083A0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine