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:
Health care specialties
| Specialty | Code | License # | 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 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497200455 | NPPES |
| Ohio | MEDICAID | 019083 |
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