Individual
ROBERT W DOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104
(215) 662-6503
Mailing address
605 W STATE ST, MEDIA, PA 19063-2620
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
MD045992L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015580110001
—
PA
Enumeration date
06/18/2006
Last updated
02/08/2011
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