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Individual

DENISE ALEJANDRA LOPEZ DOMOWICZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1021 HITT ST, COLUMBIA, MO 65212-0001
(573) 882-2272
(573) 884-5179
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
35.125972
OH
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2023042940
MO
2080P0203X
Pediatric Critical Care Medicine Physician
35.125972
OH
2080P0203X
Pediatric Critical Care Medicine Physician
ME157614
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0130903
OH
Enumeration date
05/16/2012
Last updated
05/15/2024
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