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Individual

GERALD TOMASEK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01083428A
IN
207Q00000X
Family Medicine Physician
4301105944
MI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
06/26/2014
Last updated
11/02/2023
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