Provider Demographics
NPI:1134129612
Name:TUMA, ROMAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:A
Last Name:TUMA
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 1:4201 WILSON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18020-6936
Mailing Address - Country:US
Mailing Address - Phone:610-657-1659
Mailing Address - Fax:610-924-7311
Practice Address - Street 1:4201 WILSON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18020-6936
Practice Address - Country:US
Practice Address - Phone:610-657-1659
Practice Address - Fax:610-924-7311
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-27
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423705207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011667580001Medicaid
PA1011667580001Medicaid
H31900Medicare UPIN