Provider Demographics
NPI:1821095332
Name:TOMEU, ENRIQUE J (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:J
Last Name:TOMEU
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-0187
Mailing Address - Country:US
Mailing Address - Phone:910-267-0421
Mailing Address - Fax:910-267-0441
Practice Address - Street 1:212 DUPLIN ST.
Practice Address - Street 2:
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349-6024
Practice Address - Country:US
Practice Address - Phone:910-296-0787
Practice Address - Fax:910-296-0879
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC81838207V00000X
NC9801097207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890582JMedicaid
NC890582JMedicaid