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Individual
JUAN PABLO DOMECQ GARCES
Active
Individual
JUAN PABLO DOMECQ GARCES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
63542
MN
207RN0300X
Nephrology Physician
Primary
63542
MN
207RN0300X
Nephrology Physician
70916
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497097695
—
MI
Enumeration date
03/26/2013
Last updated
10/27/2020
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