Provider Demographics
NPI:1891790978
Name:STYS, TOMASZ P (MD)
Entity Type:Individual
Prefix:
First Name:TOMASZ
Middle Name:P
Last Name:STYS
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 91407
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57109-1407
Mailing Address - Country:US
Mailing Address - Phone:605-312-7606
Mailing Address - Fax:605-312-7611
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0401
Practice Address - Country:US
Practice Address - Phone:605-328-2929
Practice Address - Fax:605-328-8429
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD5373207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6004780Medicaid
MN110009885Medicare PIN
I01870Medicare UPIN
SDS41935Medicare PIN
SD6004780Medicaid
MN110011465Medicare PIN
SDP00471866Medicare PIN
SDS101936Medicare PIN