Individual
MARTINE CATHERINE DOMANGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
533 BOLIVAR ST RM 451B, NEW ORLEANS, LA 70112-1349
(504) 568-2385
Mailing address
533 BOLIVAR ST RM 459, NEW ORLEANS, LA 70112-1349
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
313027
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2495445
—
LA
01
—
313027
LOUISIANA LICENSE
LA
01
—
CDS.055295-INT
CDS LICENSE
LA
Enumeration date
04/26/2018
Last updated
09/16/2019
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