Individual
DOMNITA CRISAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 551-7261
Mailing address
3601 W 13 MILE RD, 400-FSC/PCS, ROYAL OAK, MI 48073-6712
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
43010406945
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3348710
—
MI
Enumeration date
03/20/2006
Last updated
07/08/2007
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