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Organization
DOUGLASS T. DOMOTO, M.D., J.D., P.C.
Active
Organization
DOUGLASS T. DOMOTO, M.D., J.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLASS TAKASHI DOMOTO M.D., J.D. (PRESIDENT)
(314) 535-3720
Entity
Organization
Contact information
Practice address
2606 CLARK AVE, AVE, SAINT LOUIS, MO 63103-2502
(314) 535-3720
(314) 535-7391
Mailing address
2606 CLARK AVE, SAINT LOUIS, MO 63103-2502
(314) 535-3720
(314) 535-7391
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
R6C21
MO
Other
Enumeration date
10/05/2010
Last updated
10/05/2010
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