Kandah, Domian
Kandah, Domian is an individual health care provider with primary practice located at 11800 E 12 Mile Rd , Warren MI 48093-3472. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Kandah, Domian can be contacted via phone (586) 573-5059.Contact Information
Primary practice address
11800 E 12 Mile Rd
Warren MI 48093-3472
Phone: (586) 573-5059
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 008716 | Michigan |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 5101008716 | Michigan |
Profile Details
| NPI number | 1013954585 |
|---|---|
| LBN Legal business name | Kandah, Domian |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2006 |
| Last updated | Feb 13th, 2023 - about 3 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 | 1013954585 | NPPES |
| Michigan | MEDICAID | 112905533 | |
| Michigan | MEDICAID | 114218327 | |
| Michigan | MEDICAID | 112905758 | |
| Michigan | MEDICAID | 2791439 | |
| Michigan | MEDICAID | 112905749 | |
| Michigan | Other | 000000552888 | |
| Michigan | MEDICAID | 114206077 | |
| Michigan | Other | P00427186 | |
| Michigan | Other | DK008716 |
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