Provider Demographics
NPI:1235200478
Name:TOMSIK, PHILIP EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:EDWARD
Last Name:TOMSIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16110 DETROIT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-3715
Mailing Address - Country:US
Mailing Address - Phone:216-228-7878
Mailing Address - Fax:216-529-5051
Practice Address - Street 1:16110 DETROIT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:OH
Practice Address - Zip Code:44107-3715
Practice Address - Country:US
Practice Address - Phone:216-228-7878
Practice Address - Fax:216-529-5051
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077018T207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH45031Medicare UPIN