Individual
DR. ALEKSANDER A DOMICZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18 MARKET ST, MOUNT CLEMENS, MI 48043
(586) 783-2222
(586) 783-6280
Mailing address
6800 E 10 MILE RD, CENTER LINE, MI 48015-1167
(586) 619-9986
(586) 806-5085
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301048524
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080162065
METRAHEALTH
MI
01
—
0804400591
BLUE CROSS INDIVIDUAL
MI
01
—
0805026931
BCN IND
MI
01
—
080D410020
COMMUNITY BLUE
MA
01
—
080D410020
BLUE CROSS BLUE SHIELD
MI
01
—
0988917
HEALTH PLUS
MI
05
—
1427049683
—
MI
01
—
253226
MCLAREN HEALTH PLAN
MI
01
—
4105744
AETNA
MI
05
—
4244111
—
MI
01
—
92588990011
CIGNA
MI
01
—
B43001
HEALTH NET FEDERAL
MI
01
—
C7390
MCARE
MI
Enumeration date
11/04/2005
Last updated
07/18/2018
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