Provider Demographics
NPI:1952371882
Name:DOMSER & PLUMMER PC
Entity Type:Organization
Organization Name:DOMSER & PLUMMER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMSER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, CHT
Authorized Official - Phone:410-848-8628
Mailing Address - Street 1:731 BALTIMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6105
Mailing Address - Country:US
Mailing Address - Phone:410-848-8628
Mailing Address - Fax:410-848-3909
Practice Address - Street 1:731 BALTIMORE BLVD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6105
Practice Address - Country:US
Practice Address - Phone:410-848-8628
Practice Address - Fax:410-848-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15216225100000X
MD16859225100000X
MD17083225100000X
MD235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD211349OtherMAMSI/UHC PLANS
MD2118118OtherAETNA HMO
MDH481DOOtherCAREFIRST BC/BS
DCT615OtherCAREFIRST BLUECHOICE
MD089488580OtherTRICARE
MD5060511OtherAETNA PPO/MC
MD510BDOOtherCAREFIRST BLUECROS SPEECH
MD216588Medicare ID - Type UnspecifiedPROVIDER NUMBER