Individual
DOMINIK WILKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6170 N DURANGO DR STE 130, LAS VEGAS, NV 89149-3923
(702) 940-1550
(702) 940-1551
Mailing address
6355 S BUFFALO DR FL 3, LAS VEGAS, NV 89113-2133
(702) 216-3346
(702) 671-6883
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25970
NV
207Q00000X
Family Medicine Physician
4351048104
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972187730
—
NV
01
—
25970
STATE LICENSE
NV
Enumeration date
05/07/2021
Last updated
09/03/2024
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