Healthcare Provider Details

I. General information

NPI: 1881327716
Provider Name (Legal Business Name): CHRISTIAN L TOMSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225000 HUMMINGBIRD RD
WAUSAU WI
54401-2948
US

IV. Provider business mailing address

225000 HUMMINGBIRD RD
WAUSAU WI
54401-2948
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-6442
  • Fax: 715-393-0390
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7138-23
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: