Individual
DR. NAU DEAVIN DOMAH
Active
Individual
DR. NAU DEAVIN DOMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101245571
VA
207R00000X
Internal Medicine Physician
4301091486
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C05700
GROUP PTAN
—
01
—
C06695
GROUP PTAN
VA
01
—
C06778
GROUP PTAN
VA
Enumeration date
04/02/2008
Last updated
02/17/2014
Update your record
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