Provider Demographics
NPI:1295909661
Name:TOMCZAK, MICHAL FILIP (M D)
Entity type:Individual
Prefix:
First Name:MICHAL
Middle Name:FILIP
Last Name:TOMCZAK
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GOODRICH RD # 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2005
Mailing Address - Country:US
Mailing Address - Phone:617-522-3585
Mailing Address - Fax:
Practice Address - Street 1:10 GOODRICH RD # 1
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2005
Practice Address - Country:US
Practice Address - Phone:617-522-3585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-16
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229501207R00000X
MA242228207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine