Provider Demographics
NPI:1659351948
Name:DOMBROWSKI, HELENE CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:HELENE
Middle Name:CLAIRE
Last Name:DOMBROWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23100 CHERRY HILL ST
Mailing Address - Street 2:SUITE #10
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1493
Mailing Address - Country:US
Mailing Address - Phone:313-563-6655
Mailing Address - Fax:313-563-5517
Practice Address - Street 1:23100 CHERRY HILL ST
Practice Address - Street 2:SUITE #10
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1493
Practice Address - Country:US
Practice Address - Phone:313-563-6655
Practice Address - Fax:313-563-5517
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406059207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIBCBSMOther0708251301
MIE77890Medicare UPIN
MI0823976Medicare ID - Type UnspecifiedMEDICARE ID