MEDICARE: RICHARD M. DONNINI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0014X	Interventional Pain Medicine Physician	34.003971	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316912413
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD M. DONNINI D.O.

Provider Business Mailing Address
First Line	:	1550 YANKEE PARK PL
Second Line	:	STE A
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-1838
Country	:	US
Telephone Number	:	937-439-4949
Fax Number	:	397-439-4948

Provider Business Practice Location Address
First Line	:	1550 YANKEE PARK PL
Second Line	:	STE A
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-1838
Country	:	US
Telephone Number	:	937-439-4949
Fax Number	:	397-439-4948

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	11/09/2015

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