OMAR FERNANDO DOMINGUEZ (NPI# 1689294803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689294803 |
| Entity Type | Individual |
| Full Name | OMAR FERNANDO DOMINGUEZ |
| Credential | M.D. |
| Practice Address |
1200 Memorial Drive Hamilton Medical Center, Attn: Residency Program Dalton GA 30720 |
| Practice Telephone | 7062726132 |
| Mailing Telephone | 7062726132 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1200 MEMORIAL DRIVE HAMILTON MEDICAL CENTER, ATTN: RESIDENCY PROGRAM |
| City | DALTON |
| State | GA |
| Zip Code | 30720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831196690 | Laura Conger-moore | Internal Medicine | 1200 Memorial Drive, Dalton, GA 30720 | 2005-07-07 |
| 1023292190 | Ecc Chatsworth Dalton Mc, LLC | Emergency Medicine | 1200 Memorial Drive, Dalton, GA 30722-1168 | 2007-12-24 |
| 1851485403 | Gregory Keith Stinnett | Pharmacist | 1200 Memorial Drive, Dalton, GA 30722-1168 | 2006-10-03 |
| 1407837008 | Jerry Alan Swenson | Nurse Anesthetist, Certified Registered | 1200 Memorial Drive, Anesthesia Associates of Dalton, Dalton, GA 30720 | 2005-11-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1720620727 | Elizabeth Nicole Gregory | Behavioral Analyst | 1201 Burleyson Rd., Dalton, GA 30720 | 2019-10-10 |
| 1972161768 | Andrea Nicole Henry | Speech-Language Pathologist | 1201 Burleyson Road, Dalton, Ga. 30720, Dalton, GA 30720 | 2019-06-05 |
| 1275056905 | Cynthia L Wood | Speech-Language Pathologist | 1011 Professional Blvd., Dalton, GA 30720 | 2017-07-25 |
| 1073069225 | Alyssa Sellers Garner | Nurse Practitioner | 1436 Chattanooga Avenue, Dalton, GA 30720 | 2016-08-28 |
| 1588039077 | Katie Walker | Social Worker | 900 Shugart Road, Dalton, GA 30720 | 2015-12-09 |
| 1215310800 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 98 West Walnut Ave, Dalton, GA 30720 | 2015-07-01 |
| 1275969081 | Stacy Kay Whitehead | Nurse Practitioner | 1411 Chattanooga Avenue, Suite 101, Dalton, GA 30720 | 2013-09-25 |
| 1821439985 | Chantal Aneka Raheeda Lewis | Internal Medicine | 1109 Burleyson Rd Ste 103, Dalton, GA 30720 | 2013-07-17 |
| 1174960678 | Homestead Hospice of Northwest Georgia, LLC | Hospice Care, Community Based | 1601 Hickory Street, Dalton, GA 30720 | 2013-05-24 |
| Find all providers in zip 30720 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528688421 | Nighat Purnima Kabir | Student in an Organized Health Care Education/Training Program | Hamilton Medical Center, Attn: Residency Program, 1200 Memorial Drive, Dalton, GA 30720 | 2020-04-21 |
| 1952777385 | Diane Drosehn | Student in an Organized Health Care Education/Training Program | 139 Sunnyside Dr, Dalton, MA 01226-1045 | 2015-08-20 |
| 1265061816 | Kiranjit Singh | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1215566864 | Katelyn Amanda Boykin | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1851920409 | Bradley Sackfield | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-06 |
| 1619506557 | Kenette St-gourdin | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-03 |
| 1699304790 | Tomislav Hrvoje Jagatic | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-02 |
| 1326677428 | Daniella Eva Sankovic | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-02 |
| 1427687474 | David Ifeanyi C. Nwasike | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-02 |
| 1548899503 | Aylissa Victoria Gilbert | Student in an Organized Health Care Education/Training Program | 1200 Memorial Dr, Dalton, GA 30720-2529 | 2020-04-02 |
| Find all providers in DALTON | ||||
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| 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.