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General NPI Number Information
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NPI Number | 1093789752
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Entity Type | Individual
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Provider Name | TIMOTHY M WESTGATE O. D.
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 02/27/2018
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Provider Practice Location Address
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Address Line | 1301 BRIDGEVILLE HWY
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City | SEAFORD
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State | DE
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Zip | 19973-1616
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Country | US
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Telephone | 302-629-9197
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Fax | 302-629-3335
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Provider Business Mailing Address
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Address Line | 885 S GOVERNORS AVE
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City | DOVER
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State | DE
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Zip | 19904-4158
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Country | US
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Telephone | 302-734-5861
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Fax | 302-734-1921
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 130001190
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License Number State | DE
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