TIMOTHY EDWARD TANKE MD NPI 1780603332

NPI Information

NPI: 1780603332
Provider Name: TIMOTHY EDWARD TANKE, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

PECOS Registration: Yes

Address:
744 S WEBSTER AVE
2ND FL
GREEN BAY, WI
ZIP 54301
Phone: (920) 433-3640
Get Directions

Timothy Edward Tanke, MD is a cardiovascular disease internal medicine in Green Bay, WI with 31 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Timothy Edward Tanke, MD NPI is 1780603332. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE
Graduation Year:1993

The provider's business location address is:

744 S WEBSTER AVE
2ND FL
GREEN BAY, WI
ZIP 54301-505
Phone: (920) 433-3640
Fax: (920) 433-3705

The NPI 1780603332 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 12/20/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RI0011X	Internal Medicine	Interventional Cardiology	36179-20	WISCONSIN	No
2	207RC0000X	Internal Medicine	Cardiovascular Disease	36179	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	32340100	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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