Organization
CENTENNIAL ANESTHESIA AND PAIN MANAGEMENT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VITALIY DOMASCHEVICH MD (OWNER)
(720) 252-4590
Entity
Organization
Contact information
Practice address
15728 E PRENTICE LN, CENTENNIAL, CO 80015-4263
(720) 252-4590
Mailing address
15728 E PRENTICE LN, CENTENNIAL, CO 80015-4263
(720) 252-4590
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
CO
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
CO
Other
Enumeration date
09/20/2007
Last updated
07/21/2022
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