Individual
MAREK DOMANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W 10TH ST, ROLLA, MO 65401-2905
(573) 458-8899
Mailing address
PO BOX 220, ROLLA, MO 65402-0220
(573) 458-8899
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2005001327
MI
Other
Enumeration date
10/06/2006
Last updated
07/09/2007
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