Healthcare Provider Details

I. General information

NPI: 1023682101
Provider Name (Legal Business Name): IAN CAMPBELL TOLMIE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 BARNUM AVE
BRIDGEPORT CT
06608-2409
US

IV. Provider business mailing address

8401 MAYLAND DR # 11445
RICHMOND VA
23294-4648
US

V. Phone/Fax

Practice location:
  • Phone: 203-333-3030
  • Fax:
Mailing address:
  • Phone: 804-430-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number86497
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: