Dr Victor Luis Dominguez, MD | |
2585 W Houghton Lake Dr, Prudenville, MI 48651-9624 | |
(989) 366-2900 | |
Not Available |
Full Name | Dr Victor Luis Dominguez |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 2585 W Houghton Lake Dr, Prudenville, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184711863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 069548 (Michigan) | Primary |
Entity Name | State Of Michigan Office Of Financial Management |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508883299 PECOS PAC ID: 5496650723 Enrollment ID: O20040114000603 |
Mailing Address | Practice Location Address |
---|---|
Dr Victor Luis Dominguez, MD 2585 W Houghton Lake Dr, Prudenville, MI 48651-9624 Ph: (989) 366-2900 | Dr Victor Luis Dominguez, MD 2585 W Houghton Lake Dr, Prudenville, MI 48651-9624 Ph: (989) 366-2900 |
Dr. Nicholas William Blank, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2585 W Houghton Lake Dr, Prudenville, MI 48651 Phone: 989-366-2900 | |
Victoria Catherine Watters, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2585 W Houghton Lake Dr, Prudenville, MI 48651 Phone: 989-366-2900 Fax: 989-366-1166 |