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General NPI Number Information
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NPI Number | 1972476174
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Entity Type | Organization
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Legal Business Name | IVAN TOMEK MD PLLC
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 426 INDUSTRIAL AVE STE 130
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City | WILLISTON
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State | VT
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Zip | 05495-4449
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Country | US
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Telephone | 802-698-3762
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Fax |
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Provider Business Mailing Address
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Address Line | 1 KINGSFORD RD
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City | HANOVER
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State | NH
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Zip | 03755-2208
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Country | US
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Telephone | 603-236-9867
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. IVAN TOMEK
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Credential | MD
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Telephone | 603-236-9867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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