Organization
TEDOMER LLC
Active
Organization
TEDOMER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY NMN DOMER MD (MEDICAL DIRECTOR)
(505) 783-4045
Entity
Organization
Contact information
Practice address
3720 CHURCH ROCK RD, GALLUP, NM 87301-4572
(505) 722-2261
(505) 722-4732
Mailing address
3720 CHURCH ROCK RD, GALLUP, NM 87301-4572
(505) 722-2261
(505) 722-4732
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
12/28/2007
Last updated
01/03/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up