Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mirnouve Domond, DO

Individual provider Internal Medicine Physician · NPI 1609296052

Mirnouve Domond, DO is an Internal Medicine in Decatur, Georgia. Qualified in 2014, 12 years ago. Practices with Northside Primary Care Professional Services, LLC, a 311-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2014
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2545 Lawrenceville Hwy Ste 200
Decatur, GA 30033-3240
Phone: (770) 934-7876
Fax: (770) 491-8434
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 84233 (GA)

Record details

NPI number1609296052
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 24, 2014
Last updated in NPPESMay 22, 2024
Certification dateMay 22, 2024
Mailing address2545 Lawrenceville Hwy Ste 200, Decatur, GA 30033-3240

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Northside Primary Care Professional Services,Llc — 311 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Decatur