Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Timothy M Wallace, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1720013121

Timothy M Wallace, MD is an Anatomic Pathology & Clinical Pathology Physician in Summit, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

36500 Aurora Dr
Summit, WI 53066-4899
Phone: (262) 434-3741
Fax: (262) 434-3702
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence 41030 (WI)

Record details

NPI number1720013121
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 12, 2006
Last updated in NPPESDecember 30, 2021
Certification dateDecember 30, 2021