Individual
ORVILLE HAROLD DOMINGO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
772 PROVIDENCE RD, ALDAN, PA 19018
(610) 284-3444
(610) 284-4223
Mailing address
772 PROVIDENCE RD, ALDAN, PA 19018
(610) 284-3444
(610) 284-4223
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD036634L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006537220003
—
PA
01
—
0030820000
KHPEAST
—
01
—
4076579
USHC AETNA
—
Enumeration date
04/25/2006
Last updated
07/08/2007
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