Provider Demographics
NPI:1679928154
Name:DONARUMA, ANDREW MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MICHAEL
Last Name:DONARUMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR STE 114
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5419
Mailing Address - Country:US
Mailing Address - Phone:210-496-2669
Mailing Address - Fax:210-202-3790
Practice Address - Street 1:525 OAK CENTRE DR STE 350
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3945
Practice Address - Country:US
Practice Address - Phone:210-496-2669
Practice Address - Fax:210-202-3790
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXS3154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine