Provider Demographics
NPI:1407847700
Name:TOTH, THOMAS LOUIS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LOUIS
Last Name:TOTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-8868
Mailing Address - Fax:617-724-8882
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAW 10
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8868
Practice Address - Fax:617-724-8882
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA75925207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA724088OtherTUFTS HEALTH PLAN
MAJ12552OtherBCBS MA
MA3093557Medicaid
MA3093557Medicaid
MAJ12552Medicare ID - Type Unspecified