Provider Demographics
NPI:1063413961
Name:NEUMAN, THOMAS RAYMOND (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:RAYMOND
Last Name:NEUMAN
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 1:349 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1941
Mailing Address - Country:US
Mailing Address - Phone:330-856-2957
Mailing Address - Fax:330-856-1615
Practice Address - Street 1:349 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1941
Practice Address - Country:US
Practice Address - Phone:330-856-2957
Practice Address - Fax:330-856-1615
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-0416-N207Y00000X
PAND058750L207Y00000X
CAG67510207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0243347Medicaid
1376617613OtherNPI
OH000000211855OtherANTHEM BCBS
PA0001341761OtherHIGHMARK BC/BS
P00161841OtherRAILROAD MEDICARE
54672OtherQUALCHOICE
OH2808840Medicaid
OH660829917OtherMEDICAL MUTUAL
OH659868OtherAETNA
54672OtherQUALCHOICE
OH0243347Medicaid