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Individual
JOSE CARLOS VELASCO DI DOMENICO
Active
Individual
JOSE CARLOS VELASCO DI DOMENICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-37190
KS
207RH0000X
Hematology (Internal Medicine) Physician
04-37190
KS
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
04-37190
KS
207RH0003X
Hematology & Oncology Physician
Primary
T7760
TX
207RX0202X
Medical Oncology Physician
04-37190
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16701016
MEDICARE
KS
05
—
200587760A
—
OK
05
—
201099520A
—
KS
05
—
201099520B
—
KS
01
—
KA3434005
MEDICARE
KS
Enumeration date
10/09/2007
Last updated
12/20/2022
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