Individual
DR. NERVANE TAREK DOMLOJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7700 UNIVERSITY DR, WEST CHESTER, OH 45069-2505
(513) 585-5502
(513) 585-5511
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35.093999
OH
207L00000X
Anesthesiology Physician
4301081404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201006520
—
IN
05
—
2988950
—
OH
05
—
7100140720
—
KY
Enumeration date
12/20/2005
Last updated
05/30/2017
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