Individual
DR. LUIS P TOMACRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 HOSPITAL ROAD, EMERGENCY DEPARTMENT, INDIANA, PA 15701-0788
(724) 357-7121
(724) 357-7479
Mailing address
835 HOSPITAL ROAD, PO BOX 788, INDIANA, PA 15701-0788
(724) 357-7009
(724) 357-7414
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD056605L
PA
207Q00000X
Family Medicine Physician
MD056605L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000777968
BLUE SHIELD
PA
05
—
0015364710008
—
PA
01
—
252062
UPMC
PA
Enumeration date
10/27/2005
Last updated
05/16/2020
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