Wong, Domonique

Wong, Domonique is an individual health care provider with primary practice located at 6780 Mayfield Rd , Mayfield Hts OH 44124-2203. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wong, Domonique can be contacted via phone (440) 312-4500.

Contact Information

Primary practice address
6780 Mayfield Rd Mayfield Hts OH 44124-2203
Phone: (440) 312-4500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP.019628 Ohio

Profile Details

NPI number 1497200455
LBN Legal business name Wong, Domonique
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2016
Last updated Oct 23rd, 2019 - about 6 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1497200455 NPPES
Ohio MEDICAID 019083

Popular Providers