DR. GERALD DOMESCIK M.D. NPI 1457335101

NPI Information

NPI: 1457335101
Provider Name: DR. GERALD DOMESCIK, M.D.
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
3193 HOWELL MILL RD NW
SUITE 110
ATLANTA, GA
ZIP 30327
Phone: (404) 355-7591
Get Directions

DR. Gerald Domescik, M.D. is a diagnostic radiology radiology in Atlanta, GA. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Gerald Domescik, M.D. NPI is 1457335101. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3193 HOWELL MILL RD NW
SUITE 110
ATLANTA, GA
ZIP 30327-119
Phone: (404) 355-7591
Fax: (404) 355-9175

The NPI 1457335101 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 12/5/2005 and was last updated on 10/2/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology	012247	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	300122041	OTHER	GEORGIA	RAILROAD MEDICARE
2	202G708830	OTHER	GEORGIA	RAILROAD MEDICARE
3	300122052	OTHER	GEORGIA	RAILROAD MEDICARE
4	P00098059	OTHER	GEORGIA	RAILROAD MEDICARE
5	E54659	MEDICARE UPIN	GEORGIA
6	30BDBCG	MEDICARE ID-TYPE UNSPECIFIED	GEORGIA
7	000941553I	MEDICAID	GEORGIA
8	000941553E	MEDICAID	GEORGIA
9	30BDJSV	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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