Provider Demographics
NPI:1447235015
Name:TOMA, RAAD (MD)
Entity Type:Individual
Prefix:DR
First Name:RAAD
Middle Name:
Last Name:TOMA
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 1:15300 W 9 MILE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2585
Mailing Address - Country:US
Mailing Address - Phone:248-968-2003
Mailing Address - Fax:248-967-2276
Practice Address - Street 1:39150 DEQUINDRE RD STE 200
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-6983
Practice Address - Country:US
Practice Address - Phone:586-268-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-07
Last Update Date:2020-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301052904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1447235015Medicaid
MI700F314390OtherBLUE SHIELD
MIE49643Medicare UPIN
MI0M96210097Medicare PIN