Individual
NATHAN R DOMBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6049
(608) 756-6521
Mailing address
1000 MINERAL POINT AVE, JANESVILLE, WI 53548-2940
(608) 756-6049
(608) 756-6521
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2568023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760793012
BCBSWI
WI
05
—
1760793012
—
WI
01
—
DOMBENAT
MERCYCARE INSURANCE
WI
Enumeration date
07/01/2010
Last updated
11/04/2015
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