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Individual
MR. RICHARD JAMES DOMDERA JR.
Active
Individual
MR. RICHARD JAMES DOMDERA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35077042D
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000312579
ANTHEM INSURANCE
OH
05
—
2283176
—
OH
01
—
374
SUMMACARE INSURANCE
OH
01
—
729920
BUCKEYE COMMUNITY INSURAN
OH
01
—
97033
QUALCHOICE
OH
01
—
P00121516
RAILROAD MEDICARE
OH
01
—
Q004524
HOMETOWN INSURANCE
OH
Enumeration date
03/14/2006
Last updated
08/28/2012
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