Individual
NATALIE A DOMANGUE-SHIFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Mailing address
4740 N PENNGROVE WAY, STE 100, MERIDIAN, ID 83646
(208) 938-3663
(208) 938-3664
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-9985
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H36269
—
ID
Enumeration date
03/01/2006
Last updated
10/05/2022
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