TEDOMER LLC


Address: 3720 Church Rock Rd, Gallup, NM 87301-4572
Phone: 5057222261

TEDOMER LLC (NPI# 1033394861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1033394861
Entity Type Organization
Organization Name TEDOMER LLC
Practice Address 3720 Church Rock Rd
Gallup
NM 87301-4572
Practice Telephone 5057222261
Practice Fax Number 5057224732
Mailing Telephone 5057222261
Mailing Fax Number 5057224732
Enumeration Date 2007-12-28
Last Update Date 2008-01-03
Authorized Official Name TIMOTHY NMN DOMER (MEDICAL DIRECTOR)
Authorized Official Telephone 5057834045
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207RG0300X Internal Medicine
Specialization: Geriatric Medicine
Allopathic & Osteopathic Physicians
N 207QH0002X Family Medicine
Specialization: Hospice and Palliative Medicine
Allopathic & Osteopathic Physicians
Y 207R00000X Internal Medicine Allopathic & Osteopathic Physicians

Office Location

Street Address 3720 CHURCH ROCK RD
City GALLUP
State NM
Zip Code 87301-4572

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1154966141 Karen Marie Acuesta Arboleda Registered Nurse 516 E Nizhoni Bld., Gallup, NM 87301 2019-11-13
1811453707 Kelly Dahn Respiratory Therapist, Certified 516 E Hizhoni Blvd, Gallup, NM 87301 2019-02-15
1417411232 Frances Griego Registered Nurse 28b Alma Drive, Gallup, NM 87301 2019-01-25
1891267605 Hozho Academy Occupational Therapist 306 Nm-564, Gallup, NM 87301 2018-12-19
1922514686 Jjdac, LLC Ambulance 208 W Maloney Ave, Gallup, NM 87301 2017-12-18
1508382698 Katherine L Kuehl Pharmacist Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 2017-08-21
1497285001 Jessica Kate Savant Registered Nurse 516 E Nazhoni Blvd, Gallup, NM 87301 2017-06-15
1770013385 Nicole Aline Pavy Registered Nurse 516 E. Nizhioni Blvd, Gallup, NM 87301 2017-06-15
1730612276 Camie Renee Nelson Contractor 121 Bishop Drive, Gallup, NM 87301 2017-04-11
1508216227 Marriah Silversmith Technician, Other 3426 Blue Hill Ave, Gallup, NM 87301 2016-06-14
Find all providers in zip 87301

Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1639352834 Harsha Umesh Internal Medicine 1407 Redrock Dr, Gallup, NM 87301-5647 2007-12-11
1427123066 Leanna Marie Hoffman Internal Medicine 520 Nm Highway 564, Gallup, NM 87301-4873 2006-11-21
1225410939 Julia Noelle Beamesderfer Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2015-06-18
1306224753 Haley Thun Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2015-05-18
1154748069 Braden Mogler Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301 2014-03-28
1699111237 Benjamin Daniel Johnson Internal Medicine 516 E. Nizhoni Blvd., Gallup, NM 87301-5748 2013-05-21
1851734461 Jennifer Michelle Bass Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2013-04-12
1780943894 Duncan Randolph White Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2012-05-09
1396047908 Elizabeth Ann Ketner Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2010-12-02
1588981633 Kelvin K. Chan Internal Medicine 516 E Nizhoni Blvd, Gallup, NM 87301-5748 2010-04-29
Find all providers in GALLUP

Competitor

Search similar providers

City GALLUP
Zip Code 87301

Improve Information

Please comment or provide details below to improve the information on TEDOMER LLC.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches