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Individual

DR. MICHAEL GLENN DOMINA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
740 MIDDLE CREEK RD STE 200, SEVIERVILLE, TN 37862-5056
(865) 908-9888
Mailing address
303 SOUTH TULANE AVENUE, 5303, OAK RIDGE, TN 37830

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1630
NE
207V00000X
Obstetrics & Gynecology Physician
Primary
5095
TN
207V00000X
Obstetrics & Gynecology Physician
DO213625
OR
207V00000X
Obstetrics & Gynecology Physician
DO3503
ME
207V00000X
Obstetrics & Gynecology Physician
LT22012
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q083566
TN
Enumeration date
04/02/2015
Last updated
12/20/2024
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