Provider Demographics
NPI:1164717823
Name:DONNAL, DOMINICA P (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINICA
Middle Name:P
Last Name:DONNAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 FORBES ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1538
Mailing Address - Country:US
Mailing Address - Phone:410-263-6363
Mailing Address - Fax:
Practice Address - Street 1:200 FORBES ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1538
Practice Address - Country:US
Practice Address - Phone:410-263-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-10
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA258336208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics