Individual
DR. MATTHEW DOMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
125 S KALAMAZOO MALL, SUITE 204, KALAMAZOO, MI 49007-4832
(269) 343-3900
(269) 343-5640
Mailing address
125 S KALAMAZOO MALL, SUITE 204, KALAMAZOO, MI 49007-4832
(269) 343-3900
(269) 343-5640
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301067676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10/4450423
—
MI
05
—
10/4457925
—
MI
05
—
104686919
—
MI
Enumeration date
06/14/2006
Last updated
03/24/2010
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