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Individual

DR. JOHN MICHAEL TUMOLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 SOUTH ST, SUITE 104, SOUTHBRIDGE, MA 01550-4051
(508) 765-0636
(508) 764-4219
Mailing address
100 SOUTH ST, SUITE 104, SOUTHBRIDGE, MA 01550-4051
(508) 765-0636
(508) 764-4219

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
50918
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6176801
MA
Enumeration date
08/09/2005
Last updated
02/18/2011
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