Domjan, Daniel

Domjan, Daniel is an individual health care provider with primary practice located at 200 Southland Dr , Sikeston MO 63801-4403. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Acupuncturist, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Domjan, Daniel can be contacted via phone (573) 472-1770.

Contact Information

Primary practice address
200 Southland Dr Sikeston MO 63801-4403
Phone: (573) 472-1770
Fax: (573) 472-4050
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Acupuncturist 171100000X 118085 Missouri
Allopathic & Osteopathic Physicians / General Practice 208D00000X 118085 Missouri

Profile Details

NPI number 1235119215
LBN Legal business name Domjan, Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Mar 12th, 2020 - about 5 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 1235119215 NPPES
Missouri MEDICAID 204706030

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