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NPI Code Detail

MEDICARE: DR. KUSUM B TOM MD

MEDICARE: DR. KUSUM B TOM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0200XCritical Care Medicine (Internal Medicine) PhysicianMD419807PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1861468167
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KUSUM B TOM MD
Provider Business Mailing Address
First Line : 532 W PITTSBURGH ST
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2239
Country : US
Telephone Number : 724-454-4480
Fax Number :
Provider Business Practice Location Address
First Line : 532 W PITTSBURGH ST
Second Line :
City : GREENSBURG
State : PA
Zip : 15601-2239
Country : US
Telephone Number : 724-454-4480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 08/16/2016

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