Provider Demographics
NPI:1790746675
Name:TOMANY, KEVIN SEAN (MD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SEAN
Last Name:TOMANY
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 1:10 RESEARCH PL STE 203
Mailing Address - Street 2:
Mailing Address - City:NORTH CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01863-2439
Mailing Address - Country:US
Mailing Address - Phone:978-275-9650
Mailing Address - Fax:978-275-9552
Practice Address - Street 1:10 RESEARCH PLACE
Practice Address - Street 2:
Practice Address - City:N CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01863-2439
Practice Address - Country:US
Practice Address - Phone:978-275-9650
Practice Address - Fax:978-275-9552
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-30
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA156606207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3182622Medicaid
G11647Medicare UPIN
MA3182622Medicaid