Individual
TIMOTHY S DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 COLCHESTER AVE, WP2, 122WP2, BURLINGTON, VT 05401-1473
(802) 847-2415
Mailing address
111 COLCHESTER AVE, WP2, 122WP2, BURLINGTON, VT 05401-1473
(802) 847-2415
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
042-0011085
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1012295
—
VT
01
—
1043283013
NPI
—
Enumeration date
02/09/2006
Last updated
01/12/2015
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