Provider Demographics
NPI:1811918022
Name:TOLMAN, LEON M (MD)
Entity type:Individual
Prefix:DR
First Name:LEON
Middle Name:M
Last Name:TOLMAN
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 1:600 MEDICAL ARTS BLDG STE 610
Mailing Address - Street 2:
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-7134
Mailing Address - Country:US
Mailing Address - Phone:724-545-6625
Mailing Address - Fax:724-545-6627
Practice Address - Street 1:600 MEDICAL ARTS BLDG STE 610
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7134
Practice Address - Country:US
Practice Address - Phone:724-545-6625
Practice Address - Fax:724-545-6627
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025366E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA65773Medicare ID - Type Unspecified
PAB34736Medicare UPIN