Provider Demographics
NPI:1003873951
Name:TOMALTY, ROBERT DANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANA
Last Name:TOMALTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 FRANKLIN ST SE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4537
Mailing Address - Country:US
Mailing Address - Phone:256-539-0457
Mailing Address - Fax:256-539-5827
Practice Address - Street 1:2006 FRANKLIN ST SE
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4551
Practice Address - Country:US
Practice Address - Phone:256-539-0457
Practice Address - Fax:256-539-5827
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN480542085R0204X
AL272222085R0204X
CA1398242085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051557611Medicaid
AL126890Medicaid
AL252974Medicaid
AL51595901OtherBCBS
AL51595904OtherBCBS
AL009942888Medicaid
AL238748Medicaid
AL244377Medicaid
AL009938057Medicaid
AL009938107Medicaid
AL51067266OtherBCBS
AL51595180OtherBCBS
AL51595902OtherBCBS
AL243097Medicaid
AL243758Medicaid
AL243815Medicaid
AL245313Medicaid
AL245486Medicaid
AL51595900OtherBCBS
AL51595905OtherBCBS
AL244384Medicaid
AL135686Medicaid
AL009910971Medicaid
AL009911686Medicaid
AL009938108Medicaid
AL51595903OtherBCBS