Domke, Robert M

Domke, Robert M is an individual health care provider with primary practice located at 2598 W White River Blvd , Muncie IN 47303-5251. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Domke, Robert M can be contacted via phone (765) 747-3049.

Contact Information

Primary practice address
2598 W White River Blvd Muncie IN 47303-5251
Phone: (765) 747-3049
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 190452 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 01055190A Indiana

Profile Details

NPI number 1386681773
LBN Legal business name Domke, Robert M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Mar 23rd, 2021 - about 3 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 1386681773 NPPES
New York MEDICAID 01870382

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