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Individual
BRUCE L DOMM
Active
Individual
BRUCE L DOMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5341
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A28DO
MNBS #
ND
01
—
0106108
MEDICA #
ND
01
—
0106110
MEDICA #
ND
01
—
0108127
MEDICA #
ND
05
—
112583400
—
ND
01
—
142308
UCARE #
ND
05
—
15375
—
ND
01
—
336
NDBS #
ND
01
—
37983
SIOUX VALLEY #
ND
01
—
676560
AMERICA'S PPO/ARAZ #
ND
01
—
93416DO
MNBS 3
ND
01
—
DA9011015505
PREFERRED ONE #
ND
01
—
HP19507
HEALTHPARTNERS #
ND
01
—
ND100038
LHS #
MN
Enumeration date
07/17/2006
Last updated
10/17/2011
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