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General NPI Number Information
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NPI Number | 1730157199
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Entity Type | Individual
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Provider Name | MICHAEL TOMBERG M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 06/13/2018
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Provider Practice Location Address
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Address Line | 1344 WINTERGREEN LN NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110
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Country | US
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Telephone | 206-842-5632
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Fax | 206-842-5992
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Provider Business Mailing Address
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Address Line | 1344 WINTERGREEN LN NE
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City | BAINBRIDGE ISLAND
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State | WA
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Zip | 98110-5118
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Country | US
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Telephone | 206-842-5632
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Fax | 206-842-5992
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00037854
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License Number State | WA
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