Individual
GREGORY S DOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3735 NAZARETH RD STE 206, EASTON, PA 18045-8346
(484) 503-8281
(833) 866-5612
Mailing address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 503-8281
(833) 816-5612
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
25MA07250800
NJ
2086S0129X
Vascular Surgery Physician
MD427177
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101443016 0001
—
PA
Enumeration date
04/25/2006
Last updated
04/02/2019
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