Domangue, Martine Catherine
Domangue, Martine Catherine is an individual health care provider with primary practice located at 533 Bolivar St Rm 451B , New Orleans LA 70112-1349. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Ophthalmology. Allopathic & Osteopathic Physicians / Ophthalmology is her primary health care specialty. Domangue, Martine Catherine can be contacted via phone (504) 568-2385.Contact Information
Primary practice address
533 Bolivar St Rm 451B
New Orleans LA 70112-1349
Phone: (504) 568-2385
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 313027 | Louisiana |
Profile Details
| NPI number | 1649768516 |
|---|---|
| LBN Legal business name | Domangue, Martine Catherine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2018 |
| Last updated | Sep 16th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649768516 | NPPES |
| Louisiana | Other | CDS.055295-INT | CDS LICENSE |
| Louisiana | MEDICAID | 2495445 | CDS LICENSE |
| Louisiana | Other | 313027 | CDS LICENSE |
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