Basic Information
| Provider Information | |||||||||
| NPI: | 1306837265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOMZAK | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 CHARLES ST | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224013346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403681986 | ||||||||
| FaxNumber: | 5403685206 | ||||||||
| Practice Location | |||||||||
| Address1: | 2300 CHARLES ST | ||||||||
| Address2: | |||||||||
| City: | FREDERICKSBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 224013346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5403681986 | ||||||||
| FaxNumber: | 5403685206 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 0101038219 | VA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.