Individual
RENEE S. DOMANICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 MEDICAL CENTER DR, SUITE 3500, HUNTINGTON, WV 25701-3656
(304) 691-1300
(304) 691-1375
Mailing address
1600 MEDICAL CENTER DR, SUITE 3500, HUNTINGTON, WV 25701-3656
(304) 691-1300
(304) 691-1375
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
17906
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0109276000
—
WV
05
—
0993555
—
OH
05
—
64700503
—
KY
Enumeration date
04/12/2006
Last updated
09/26/2012
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