Domangue-Shiflett, Natalie A
Domangue-Shiflett, Natalie A is an individual health care provider with primary practice located at 4740 N Penngrove Way Ste 100, Meridian ID 83646. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Domangue-Shiflett, Natalie A can be contacted via phone (208) 938-3663.Contact Information
Primary practice address
4740 N Penngrove Way Ste 100
Meridian ID 83646
Phone: (208) 938-3663
Fax: (208) 938-3664
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M-9985 | Idaho |
Profile Details
| NPI number | 1376510123 |
|---|---|
| LBN Legal business name | Domangue-Shiflett, Natalie A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 1st, 2006 |
| Last updated | Oct 5th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376510123 | NPPES |
| Idaho | MEDICAID | H36269 |
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