Individual
DR. DOMINIC CARL FANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1000 HARRINGTON BLVD., MOUNT CLEMENS, MI 48043-2920
(586) 493-3727
Mailing address
1000 HARRINGTON BLVD., MOUNT CLEMENS, MI 48043-2920
(586) 493-3727
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101020631
MI
Other
Enumeration date
07/03/2013
Last updated
04/12/2021
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