Provider Demographics
NPI:1326046830
Name:TOMEO, MICHAEL A (MD)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:TOMEO
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 1:3500 N BROAD ST # 1A
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4106
Mailing Address - Country:US
Mailing Address - Phone:215-707-2433
Mailing Address - Fax:
Practice Address - Street 1:610 FARM LANE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4753
Practice Address - Country:US
Practice Address - Phone:215-728-2754
Practice Address - Fax:215-214-3992
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031507E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0057026000OtherKEYSTONE HEALTHPLAN EAST
PA57566OtherAETNA
PA57566OtherAETNA
PA57566OtherAETNA
PA232591266OtherTAX ID NUMBER