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General NPI Number Information
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NPI Number | 1588796155
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Entity Type | Individual
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Provider Name | SZU-WEI T DOMINGUE M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 01/29/2023
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Provider Practice Location Address
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Address Line | 3301 DEBORAH DR
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City | MONROE
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State | LA
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Zip | 71201-2150
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Country | US
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Telephone | 318-325-0958
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 DEBORAH DR
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City | MONROE
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State | LA
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Zip | 71201-2150
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Country | US
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Telephone | 318-355-8152
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 021807
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License Number State | LA
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