Jon Paul Doman, R.PH.
Individual provider Active NPI Pharmacist · Romulus, MI
NPI 1134597586 · NPPES record last updated Feb 26, 2020
Key facts
- NPI
- 1134597586
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302026267 (MI)
- Practice address
- 36567 Goddard Rd
Romulus, MI 48174-1232 - Phone
- (734) 941-0755
- Fax
- (734) 941-8771
- NPI assigned
- Sep 2, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302026267 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302026267 | MI | Yes |
Addresses
Primary practice location
36567 Goddard Rd
Romulus, MI 48174-1232
Mailing address
36567 Goddard Rd
Romulus, MI 48174-1232
Phone (734) 941-0755
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302026267 | Other | MI | STATE OF MICHIGAN DEPT OF LICENSING AND REGULATORY AFFAIRS |
Other providers in Romulus, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.