Individual
DR. KERRY MICHAEL DONEGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Mailing address
2535 IRA E WOODS AVE, GRAPEVINE, TX 76051-3930
(817) 481-2121
(817) 488-4493
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G9848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135607305
—
TX
01
—
82X721
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/21/2005
Last updated
04/27/2020
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