Provider Demographics
NPI:1851643050
Name:SYMPTOM MANAGEMENT SPECIALIST, PC
Entity type:Organization
Organization Name:SYMPTOM MANAGEMENT SPECIALIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONATO
Authorized Official - Middle Name:GAERLAN
Authorized Official - Last Name:DUMLAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:251-625-6896
Mailing Address - Street 1:29653 ANCHOR CROSS BLVD
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-9594
Mailing Address - Country:US
Mailing Address - Phone:251-625-6896
Mailing Address - Fax:251-625-6897
Practice Address - Street 1:29653 ANCHOR CROSS BLVD
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9594
Practice Address - Country:US
Practice Address - Phone:251-625-6896
Practice Address - Fax:251-625-6897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25803207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALH48676Medicare UPIN
AL139SL1Medicare PIN