# BRUCE L DOMM

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1730106329
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 5341 | ND | Yes |

## Other

- **Enumeration date:** 07/17/2006
- **Last updated:** 10/17/2011

## 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 |