Individual
CHAD M DOMANGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
76 STARBRUSH CIR, COVINGTON, LA 70433-7208
(985) 801-0581
Mailing address
76 STARBRUSH CIR, COVINGTON, LA 70433-7208
(985) 801-0581
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
TP-366
KY
208VP0014X
Interventional Pain Medicine Physician
Primary
202018
LA
Other
Enumeration date
05/21/2007
Last updated
03/05/2015
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