Individual
BOBBY TOLOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 N SAWYER RD, KENDALLVILLE, IN 46755-2572
(260) 347-8030
(260) 347-8035
Mailing address
3702 NEW VISION DR BLDG B, FORT WAYNE, IN 46845-1703
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01078773A
IN
207V00000X
Obstetrics & Gynecology Physician
20152
NE
207V00000X
Obstetrics & Gynecology Physician
32336
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025323300
—
NE
05
—
2169730
—
IA
Enumeration date
06/22/2006
Last updated
03/02/2020
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