Provider Demographics
NPI:1982665980
Name:HOMAN, DOMINIC F (MD)
Entity Type:Individual
Prefix:DR
First Name:DOMINIC
Middle Name:F
Last Name:HOMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE #305
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1134
Mailing Address - Country:US
Mailing Address - Phone:256-494-0990
Mailing Address - Fax:256-494-0948
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:SUITE #305
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1134
Practice Address - Country:US
Practice Address - Phone:256-494-0990
Practice Address - Fax:256-494-0948
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00022313207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051041014OtherBLUE CROSS BLUE SHIELD
AL000041014Medicaid
G59563Medicare UPIN
AL000041014Medicaid