Provider Demographics
NPI:1952413692
Name:TOMAN, LEE A (MD)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:A
Last Name:TOMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:989 LOMBARD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-3254
Mailing Address - Country:US
Mailing Address - Phone:651-291-0053
Mailing Address - Fax:
Practice Address - Street 1:1690 UNIVERSITY AVE W
Practice Address - Street 2:STE. 570
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-3723
Practice Address - Country:US
Practice Address - Phone:651-232-4800
Practice Address - Fax:651-232-4899
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN28231207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND81937Medicare UPIN