NPI 1003135500

Michael Matthew Dominello, DO

Practitioner Radiation Oncology Physician Detroit, MI

Practice location

Address: 4100 John R, Detroit, MI 48201-2013
Phone: (800) 527-6266
Fax: (313) 576-9640
Mailing address: 1560 E Maple Rd Suite 400 - Credentialing Department, Troy, MI 48083-1138

Registered specialties

Radiation Oncology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0001X Licence 5101019388 (MI)

Other Radiology providers in Michigan →

Registry record

NPI: 1003135500
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 May 2010
Record last updated: 28 Jul 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.