Healthcare Provider Details

I. General information

NPI: 1952413692
Provider Name (Legal Business Name): LEE A TOMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1690 UNIVERSITY AVE W STE. 570
SAINT PAUL MN
55104-3723
US

IV. Provider business mailing address

989 LOMBARD AVE
SAINT PAUL MN
55105-3254
US

V. Phone/Fax

Practice location:
  • Phone: 651-232-4800
  • Fax: 651-232-4899
Mailing address:
  • Phone: 651-291-0053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number28231
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: