Provider Demographics
NPI:1447830716
Name:TOMCZAK, LUKE (MD)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:TOMCZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23504-1206
Mailing Address - Country:US
Mailing Address - Phone:810-965-5086
Mailing Address - Fax:
Practice Address - Street 1:358 MOWBRAY ARCH
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-2219
Practice Address - Country:US
Practice Address - Phone:757-388-0324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2022-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program