Michael A Domino PA-C

NPI 1689837916 - Physician Assistant - 363A00000X

NPI Details
NPI 1689837916
Gender Male
Enumeration Date 07/07/2008
Last Updated 07/07/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
505 ELM ST NE
ALBUQUERQUE NM, 87102-2500, US
Phone (505) 238-2027
Fax
Business Location
2704 SIERRA DR NE
ALBUQUERQUE NM, 87110-2944, US
Phone (505) 238-2027
Fax
Toxanomy
Taxonomy Code 363A00000X
License State New Mexico
License Number PA2008-0031
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According to our database, Mr. Michael A Domino PA-C NPI is 1689837916, taxonomy code is 363A00000X and license number is PA2008-0031, license state is located at New Mexico. Michael A Domino PA-C physically located at 505 Elm St Ne, Albuquerque NM, 87102-2500. NPI Number Michael A Domino PA-C has the Individual type.

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1689837916 NPI number is provided on an as is basis without warranty of any kind. 1689837916 is maintained by the National Plan & Provider Enumeration System. The contents of Michael A Domino PA-C are for informational purposes only.