Domatova, Marina

Domatova, Marina is an individual health care provider with primary practice located at 1 Medical Park , Wheeling WV 26003-6379. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Domatova, Marina can be contacted via phone (304) 243-3330.

Contact Information

Primary practice address
1 Medical Park Wheeling WV 26003-6379
Phone: (304) 243-3330
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 32484 West Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 012873 New York

Profile Details

NPI number 1235369265
LBN Legal business name Domatova, Marina
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2009
Last updated Sep 5th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235369265 NPPES
West Virginia Other 32484 LICENSE
West Virginia Other 012873 LICENSE
West Virginia Other D0095827 LICENSE

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