Healthcare Provider Details
I. General information
NPI: 1972785319
Provider Name (Legal Business Name): TORMOD SCHUMACHER WESTVIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/28/2007
Last Update Date: 01/26/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
20 YORK ST T-209
NEW HAVEN CT
06510-3220
US
IV. Provider business mailing address
20 YORK ST T-209
NEW HAVEN CT
06510-3220
US
V. Phone/Fax
- Phone: 203-688-2259
- Fax: 203-688-5599
- Phone: 203-688-2259
- Fax: 203-688-5599
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | 79766 |
| License Number State | CT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: