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Individual
DOMINIQUE F CHAMPION
Active
Individual
DOMINIQUE F CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601013904
MI
363A00000X
Physician Assistant
Primary
PA1929
NV
363AS0400X
Surgical Physician Assistant
10004488A
IN
363AS0400X
Surgical Physician Assistant
PA-1334
AR
Other
Enumeration date
01/08/2018
Last updated
05/07/2026
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