Individual
MACIEJ STANISLAW TOBOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 KINGSLEY LN STE 305, NORFOLK, VA 23505-4617
(757) 889-5422
(757) 889-5450
Mailing address
110 KINGSLEY LN STE 305, NORFOLK, VA 23505-4617
(757) 889-5422
(757) 889-5450
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101258213
VA
2085R0202X
Diagnostic Radiology Physician
4301094374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154559805
—
VA
Enumeration date
07/01/2009
Last updated
06/19/2019
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