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Ian J Dominguez, DO
Student in an Organized Health Care Education/Training Program in Warren, Michigan
NPI 1952097065

Ian J Dominguez is a Student in an Organized Health Care Education/Training Program based in Warren, MI. Ian J Dominguez practices in Warren, MI and has the professional credentials of DO. The NPI Number for Ian J Dominguez is 1952097065 and holds a License No. (Michigan).

The current practice location address for Ian J Dominguez is 11885 E 12 Mile Rd Ste 300A, Warren, MI and can be reached out via phone at 586-573-7470 and via fax at 586-573-0850.

Location: 11885 E 12 Mile Rd Ste 300A, Warren, MI, 48093-3467
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952097065
Provider Name
Ian J Dominguez
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
11885 E 12 Mile Rd Ste 300A, Warren, MI, 48093-3467
Phone Number
586-573-7470
Fax Number
586-573-0850
Provider Enumeration Date
04/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
11885 E 12 Mile Rd Ste 300A
City
Warren
State
Michigan
Zip
48093-3467
Phone Number
586-573-7470
Fax Number
586-573-0850
person
Provider Business Mailing Address Details
Address
11885 E 12 Mile Rd Ste 300A
City
Warren
State
Michigan
Zip
48093-3467
Phone Number
586-573-7470
Fax Number
586-573-0850
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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