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Individual
LAWRENCE DIDOMENICO
Active
Individual
LAWRENCE DIDOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
236
WV
213E00000X
Podiatrist
Primary
36-00-2513
OH
213E00000X
Podiatrist
SC-00-3181
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01145989
—
PA
05
—
0712232
—
OH
01
—
1013181-1045507
WORKERS COMP
WV
01
—
4117771
AETNA
—
01
—
539836
HIGHMARK
—
05
—
6420012
—
WV
01
—
P02513
THE HEALTH PLAN
—
Enumeration date
07/07/2005
Last updated
02/21/2019
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