Doromal, Joseph Vincent Bautista

Doromal, Joseph Vincent Bautista is an individual health care provider with primary practice located at 111 Mountain Brook Dr , Canton GA 30115-9045. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Doromal, Joseph Vincent Bautista can be contacted via phone (678) 880-9654.

Contact Information

Primary practice address
111 Mountain Brook Dr Canton GA 30115-9045
Phone: (678) 880-9654
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X RN240795 Georgia

Profile Details

NPI number 1891286928
LBN Legal business name Doromal, Joseph Vincent Bautista
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2018
Last updated May 24th, 2018 - about 8 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.

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