DR. EVILLO M DOMINGO (NPI# 1770587693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770587693 |
| Entity Type | Individual |
| Full Name | DR. EVILLO M DOMINGO |
| Credential | MD |
| Practice Address |
25 Spring St Plymouth OH 44865 |
| Mailing Address |
2750 Neal Zick Rd Willard OH 44890-9282 |
| Practice Telephone | 4196875781 |
| Practice Fax Number | 4196875018 |
| Mailing Telephone | 5672240854 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2018-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 35-07-4369-D | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2083972 | 05 |
| Street Address |
25 SPRING ST |
| City | PLYMOUTH |
| State | OH |
| Zip Code | 44865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093236010 | Nicole Lerae Varkonda | Social Worker | 4181 Townline Road 111, Plymouth, OH 44865 | 2017-06-29 |
| 1437443942 | Kathy Ann Goble | Licensed Practical Nurse | 8247 State Route 61 Lot #22, Plymouth, OH 44865 | 2011-06-01 |
| 1114153020 | Rachel Ann Mcclary | Licensed Practical Nurse | 101 Plymouth St, Plymouth, OH 44865-1009 | 2009-06-05 |
| 1306080247 | Jamie L Montgomery | Licensed Practical Nurse | 159 Railroad St, Plymouth, OH 44865-1050 | 2009-04-22 |
| 1033329123 | Jeffery B. Stoller D.d.s I.n.c | Dentist | 4 E Main St, Plymouth, OH 44865-1081 | 2007-05-23 |
| 1164632253 | Emily Fries | Dental Hygienist | 4 E Main St, Plymouth, OH 44865-1081 | 2007-05-23 |
| 1811106420 | Jeffery Stoller | Dentist | 4 E Main St, Plymouth, OH 44865-1081 | 2007-05-21 |
| 1962654731 | James Edgar Lundeen Sr. | Physical Medicine & Rehabilitation | 26 Sandusky St, Plymouth, OH 44865-1113 | 2008-10-10 |
| 1346485380 | Plymouth-shiloh Local Schools | Local Education Agency (LEA) | 365 Sandusky St, Plymouth, OH 44865-1135 | 2008-12-04 |
| 1134434772 | Tina Faye Gibson | Licensed Practical Nurse | 63 Park Ave, Plymouth, OH 44865-1148 | 2010-08-06 |
| Find all providers in zip 44865 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265996219 | Housecall Physicians, Inc | Family Medicine | 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 | 2019-01-24 |
| 1215445994 | Jefferson Community Health Center Inc | Family Medicine | 316 N Madison Ave, Ste 200, Plymouth, NE 68424-4110 | 2018-01-17 |
| 1124551833 | Xpress Urgent Care PC | Family Medicine | 49237 Fox Dr N, Plymouth, MI 48170-5205 | 2017-04-10 |
| 1952853525 | Ann Curoe | Family Medicine | 10835 38th Pl N, Plymouth, MN 55441-1409 | 2016-10-31 |
| 1639429558 | Carol Elizabeth Ness | Family Medicine | 1145 Shenandoah Ln N, Plymouth, MN 55447-3201 | 2012-09-18 |
| 1881953461 | Ronald Carl Skoogberg | Family Medicine | 3025 Harbor Lane, Suite 101, Plymouth, MN 55447-5141 | 2012-05-16 |
| 1093955700 | Soliman Home Visiting Physicians Pllc | Family Medicine | 12173 Chandler Dr, Plymouth, MI 48170-3193 | 2009-02-20 |
| 1457508079 | Chaitra Channappa | Family Medicine | 31 Home Depot Dr Ste 283, Plymouth, MA 02360-2669 | 2008-08-26 |
| 1730365388 | Milton Delin Westberg | Family Medicine | 1010 Wilson St, Plymouth, NC 27962-9185 | 2008-01-14 |
| 1194849398 | Michael A Martella | Family Medicine | 515 E Mill Street, Plymouth, WI 53073-1807 | 2007-03-16 |
| Find all providers in PLYMOUTH | ||||
Please comment or provide details below to improve the information on DR. EVILLO M DOMINGO.
| 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.