Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 076507 | GA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 076507 | GA |
NPI | 1295762375 |
---|---|
Provider Name | Dr. Stephen H Tomek |
First Address | Macon, GA 31201-2102 |
Second Address | Macon, GA 31201-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 02/09/2020 |