Individual
DR. WILLIAM K. DOMARAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
02003790A
IN
2084N0400X
Neurology Physician
2011011659
MO
2084N0400X
Neurology Physician
7330
SD
2084N0400X
Neurology Physician
DO-04320
IA
2084N0400X
Neurology Physician
Primary
OP00001949
WA
2084N0600X
Clinical Neurophysiology Physician
O-1291
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000756863
ANTHEM (REID PHYSICIAN ASSOCIATES, INC.)
—
01
—
000010148189
REGENCE BLUE SHIELD OF ID
ID
05
—
0109759
—
OH
05
—
201057130
—
IN
05
—
806992600
—
ID
01
—
S5247
BLUE CROSS OF IDAHO
ID
Enumeration date
08/05/2006
Last updated
08/11/2026
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