Individual
LEE ROBERT DOMANGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 MEDICAL CENTER DRIVE, SLIDELL, LA 70461-5520
(985) 646-5189
Mailing address
1514 JEFFERSON HIGHWAY, NEW ORLEANS, LA 70121
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
013775
LA
207P00000X
Emergency Medicine Physician
Primary
MD.013775
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04888790
—
MS
05
—
1195529
—
LA
Enumeration date
05/30/2006
Last updated
10/03/2011
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