Provider Demographics
NPI:1033320791
Name:TOMCO, ABRAHAM R (MD)
Entity Type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:R
Last Name:TOMCO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1055 N 500 W
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3305
Mailing Address - Country:US
Mailing Address - Phone:801-354-8225
Mailing Address - Fax:801-418-0941
Practice Address - Street 1:700 W 800 N
Practice Address - Street 2:SUITE 220
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6301
Practice Address - Country:US
Practice Address - Phone:801-354-8205
Practice Address - Fax:801-354-8206
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-11-27
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Provider Licenses
StateLicense IDTaxonomies
UT6837325-1205207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine