Domian Kandah
Emergency Medical Services
11800 E 12 Mile Rd
Warren
, Michigan 48093-3472
Domian Kandah
Emergency Medical Services
11800 E 12 Mile Rd
Warren
, Michigan 48093-3472
(856) 686-4308
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Domian Kandah
- 307 S Evergreen Ave
- Woodbury, NJ
- Zip : 08096-2739
- Phone : (856) 686-4308
Second Address
- Domian Kandah
- 11800 E 12 Mile Rd
- Warren, MI
- Zip : 48093-3472
- Phone : (586) 573-5059
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | 008716 | MI |
National Provider Identifier
| NPI | 1013954585 |
|---|---|
| Provider Name | Domian Kandah |
| First Address | Woodbury, NJ 08096-2739 |
| Second Address | Warren, MI 48093-3472 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/06/2006 |
| Last Update Date | 31/10/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 000000552888 | ANTHEM/BCBS (01) | OH |
| 112905533 | (05) | MI |
| 112905749 | (05) | MI |
| 112905758 | (05) | MI |
| 114206077 | (05) | MI |
| 114218327 | (05) | MI |
| 2791439 | (05) | OH |
| DK008716 | BLUE SHIELD (01) | MI |
| F16753 | (02) | |
| P00427186 | MEDICARE RAILROAD (01) | OH |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.