Domer, Andrew Richard
Domer, Andrew Richard is an individual health care provider with primary practice located at 3920 N Union Blvd Ste 330 , Colorado Springs CO 80907-4916. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Domer, Andrew Richard can be contacted via phone (719) 570-7272.Contact Information
Primary practice address
3920 N Union Blvd Ste 330
Colorado Springs CO 80907-4916
Phone: (719) 570-7272
Fax: (719) 570-9030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 4155 | Colorado |
Profile Details
| NPI number | 1841231230 |
|---|---|
| LBN Legal business name | Domer, Andrew Richard |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jun 11th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841231230 | NPPES |
| Other | 11561458 | CAQH NUMBER |
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