Individual
DOMINIQUE MICHELLE DONATELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9493
(616) 364-7347
Mailing address
2712 MIRACLE LN NE, GRAND RAPIDS, MI 49525
(630) 776-4594
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4351047691
MI
Other
Enumeration date
05/06/2021
Last updated
06/12/2025
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