Individual
DR. VITALIY DOMASHEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14100 E ARAPAHOE RD, SUITE B110, CENTENNIAL, CO 80112-4028
(720) 870-7446
(720) 870-7460
Mailing address
PO BOX 3405, GREENWOOD VILLAGE, CO 80155-3405
(720) 870-7446
(720) 870-7460
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
041756
CO
207L00000X
Anesthesiology Physician
MD28222
ME
207LP2900X
Pain Medicine (Anesthesiology) Physician
41756
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0971244
—
CO
05
—
1235165400
—
ME
Enumeration date
06/23/2006
Last updated
05/03/2024
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