Provider Demographics
NPI:1033829577
Name:DOMFEH PLLC
Entity Type:Organization
Organization Name:DOMFEH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:YAW
Authorized Official - Last Name:DOMFEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-432-5144
Mailing Address - Street 1:1546 W GRISWOLD RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-5433
Mailing Address - Country:US
Mailing Address - Phone:602-432-5144
Mailing Address - Fax:
Practice Address - Street 1:11411 N 19TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-3642
Practice Address - Country:US
Practice Address - Phone:602-256-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty