Provider Demographics
NPI:1972838456
Name:TOMAREV, NADEJDA (MD)
Entity Type:Individual
Prefix:MRS
First Name:NADEJDA
Middle Name:
Last Name:TOMAREV
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:NADEJDA
Other - Middle Name:
Other - Last Name:LEUKINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1161 OMEGA DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5574
Mailing Address - Country:US
Mailing Address - Phone:301-393-2600
Mailing Address - Fax:
Practice Address - Street 1:1161 OMEGA DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5574
Practice Address - Country:US
Practice Address - Phone:301-393-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD69843208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028738500Medicaid