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Individual
MIKHAIL V DOMNINE
Active
Individual
MIKHAIL V DOMNINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
001001114
NC
363A00000X
Physician Assistant
Primary
C0009827
MD
363A00000X
Physician Assistant
MA052604
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
164XJ
BCBSNC
NC
01
—
2687
EVOLUTIONS HEALTHCARE SYSTEMS
NC
01
—
7790899
AETNA
NC
Enumeration date
10/20/2006
Last updated
07/29/2025
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