Individual
PATRICK J TOMBOC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1775 DEMPSTER ST, PARK RIDGE, IL 60068-1143
(123) 456-7890
Mailing address
MEDICAL CENTER DR, MORGANTOWN, WV 26505
(304) 598-4800
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
3051
WV
390200000X
Student in an Organized Health Care Education/Training Program
125-054771
IL
Other
Enumeration date
08/01/2008
Last updated
04/15/2022
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