Individual
DOMINIQUE F CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3150 N TENAYA WAY STE 260, LAS VEGAS, NV 89128-0459
(702) 962-5920
(702) 240-9984
Mailing address
4000 WELLNESS DR, MIDLAND, MI 48670-1000
(844) 832-1956
(989) 633-5241
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601013904
MI
363A00000X
Physician Assistant
Primary
PA1929
NV
363AS0400X
Surgical Physician Assistant
10004488A
IN
363AS0400X
Surgical Physician Assistant
PA-1334
AR
Other
Enumeration date
01/08/2018
Last updated
05/07/2026
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