Organization
BLUEMONT PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK CHRISTIAN DOMANSKI M.D. (PRESIDENT)
(703) 596-1660
Entity
Organization
Contact information
Practice address
8316 ARLINGTON BLVD STE 524, FAIRFAX, VA 22031-5216
(703) 596-1660
Mailing address
8316 ARLINGTON BLVD STE 524, FAIRFAX, VA 22031-5216
(703) 596-1660
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
0101257764
VA
208200000X
Plastic Surgery Physician
0101257764
VA
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
04/24/2015
Last updated
07/18/2023
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