Dominguez, Jesus H

Dominguez, Jesus H is an individual health care provider with primary practice located at 1481 W 10Th St C7173, Indianapolis IN 46202-2803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Dominguez, Jesus H can be contacted via phone (317) 274-7453.

Contact Information

Primary practice address
1481 W 10Th St C7173 Indianapolis IN 46202-2803
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 01034356 Indiana

Profile Details

NPI number 1376501478
LBN Legal business name Dominguez, Jesus H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Jan 21st, 2021 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376501478 NPPES
Indiana MEDICAID 100260790

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