Individual
ROBERT L TOMSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
4717 ST ANTOINE, KRESGE EYE INSTITUTE, DETROIT, MI 48201-1423
(313) 577-8900
(313) 577-0700
Mailing address
1560 E. MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5976
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
35-043259
OH
207W00000X
Ophthalmology Physician
Primary
4301095698
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000221074
UNISON
OH
01
—
000000510698
ANTHEM
OH
05
—
0445718
—
OH
01
—
130023873
MCR RR
—
01
—
2386992
AETNA
OH
01
—
364082
WELLCARE MEDICAID
OH
01
—
738110
BUCKEYE MEDICAID
OH
01
—
P00398391
RAILROAD MEDICARE
OH
Enumeration date
07/25/2006
Last updated
11/10/2015
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