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General NPI Number Information
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NPI Number | 1336199975
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Entity Type | Individual
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Provider Name | TOMAS WILLIAM ABALO M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 325 E H ST
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City | IRON MOUNTAIN
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State | MI
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Zip | 49801-4760
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Country | US
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Telephone | 906-774-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 305 SCENIC CIR
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City | MIDLAND
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State | MI
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Zip | 48642-7196
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Country | US
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Telephone | 989-941-1358
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 10097
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 4301073402
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301073402
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License Number State | MI
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