Provider Demographics
NPI:1255490512
Name:KALKIEWICZ, THOMAS JR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:KALKIEWICZ
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:319 N POTTSTOWN PIKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2218
Mailing Address - Country:US
Mailing Address - Phone:610-280-7700
Mailing Address - Fax:610-280-7593
Practice Address - Street 1:319 N POTTSTOWN PIKE
Practice Address - Street 2:SUITE 205
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2218
Practice Address - Country:US
Practice Address - Phone:610-280-7700
Practice Address - Fax:610-280-7593
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD056957L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics