Mary M Domville is a Medical in Carrollton, Georgia. Mary M Domville practices all healthcare services and medical treatments related to Medical. The NPI Number for Mary M Domville is 1578573820. The last update date is 2009-02-13.
Mary M Domville's current location address is 524 Dixie St, Carrollton, Georgia. You can contact this provider via phone number 7708322775 and fax number 7702548680. The mailing address for Mary M Domville is 524 Dixie St, Carrollton, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mary M Domville |
|---|---|
| Address | 524 Dixie St, Carrollton, Georgia |
| Phone Number | 7708322775 |
| Fax Number | 7702548680 |
| Sole Proprietor | N |
| Credentials | P.A. |
NPI Number Detail
| NPI Number | 1578573820 |
|---|---|
| Provider Enumeration Date | 2006-08-09 |
| Last Updated Date | 2009-02-13 |
Provider Mailing Address Detail
| Address | 524 Dixie St |
|---|---|
| City | Carrollton |
| State | Georgia (GA) |
| Post Code | 301173805 |
| Phone Number | 7708322775 |
| Fax Number | 7702548680 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 3494 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 3494 | GA | STATE LICENSE |
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What is the unique 10-digit identification code assigned to Mary M Domville by the Centers for Medicare & Medicaid Services?
The Mary M Domville has been issued the NPI (National Provider Identifier) 1578573820, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Mary M Domville located?
The Mary M Domville is located at 524 Dixie St, Carrollton, GA 301173805.
What is Mary M Domville's specialized field of practice, and what is the corresponding taxonomy classification code?
The Mary M Domville's area of specialization is Medical, and the corresponding taxonomy code that categorizes this field of practice is 363Am0700X.
When did the Mary M Domville receive its 1578573820?
The Mary M Domville was issued its 1578573820 on 2006-08-09, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Mary M Domville last refreshed?
The information related to the Mary M Domville, including its address, specialty, and other relevant details, was last updated on 2009-02-13.