Provider Demographics
NPI:1174727580
Name:TOMA, ROGER SABAH (MD)
Entity type:Individual
Prefix:DR
First Name:ROGER
Middle Name:SABAH
Last Name:TOMA
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 1:2421 MONROE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-3043
Mailing Address - Country:US
Mailing Address - Phone:313-562-4100
Mailing Address - Fax:
Practice Address - Street 1:2421 MONROE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-3043
Practice Address - Country:US
Practice Address - Phone:313-562-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082081207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology