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ALBERT T. DOMINGO MS MD INC

Other Service Providers Specialist

Provider NPI: 1164582631

Organization Information:
Organization Name:  ALBERT T. DOMINGO MS MD INC
Organization is not Subpart
Authorized Official:  ALBERT T. DOMINGO  PRESIDENT  330-452-9460

Practice Location:
3120 PARKWAY ST NW SUITE A CANTON, OH 44708-3981 US
Tel: 330-452-9460  Fax: 330-452-9520

Business Mailing Address:
3120 PARKWAY ST NW SUITE A CANTON, OH 44708-3981 US
Tel: 330-452-9460  Fax: 330-452-9520

NPI Information:
NPI: 1164582631
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y174400000XOther Service Providers
Specialist
OH49267

Other Provider Identifiers:

IssuerNumberStateType
0544370OH05



American Medical Association 2012 taxonomy code information

Code: 174400000X

Type:

Classification:



Definition:



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