Doctor Name: | MS. TABATHA ALMA TOMAJKO |
NPI Number: | 1013019108 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 2898 |
Business Practice Address: | 300 Exempla Circle, Suite 360 Bluestone Advanced Surgical Care Lafayette, CO - 80026 |
Business Phone Number: | 3036896560 |
Business Fax Number: | |
Mailing Address: | 1995 E Coalton Rd, Apt 76-101 SUPERIOR |
State: | CO |
Postal Code: | 800274419 |
Phone Number: | 2039401367 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2006 |
NPI Last Update Date: | 12/02/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 2898 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |