Individual
JACQUELIN DOMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 WISCONSIN AVE, BETHESDA, MD 20889-0004
(248) 797-6227
Mailing address
1828 W HOUSTONIA AVE, ROYAL OAK, MI 48073-3994
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0102209632
VA
Other
Enumeration date
03/15/2024
Last updated
10/15/2025
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