Provider Demographics
NPI:1285609875
Name:STORM, DONALD F (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:F
Last Name:STORM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3085 SOUTHWESTERN BLVD
Mailing Address - Street 2:STE 104
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1233
Mailing Address - Country:US
Mailing Address - Phone:716-674-1292
Mailing Address - Fax:716-677-4314
Practice Address - Street 1:3085 SOUTHWESTERN BLVD
Practice Address - Street 2:STE 104
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1233
Practice Address - Country:US
Practice Address - Phone:716-674-1292
Practice Address - Fax:716-677-4314
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY123440208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00611427Medicaid
1200623OtherINDEPENDENT HEALTH
000101737001OtherUNIVERA HEALTHCARE
000507133001OtherBCBS OF WESTERN NEW YORK