Individual
DR. MICHAEL TOBEH KOMETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
(804) 765-5244
Mailing address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5991
(804) 765-5244
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
0101249428
VA
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
KOME3968700
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700042231
—
VA
Enumeration date
08/04/2008
Last updated
04/26/2019
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