Individual
ANTONIO ALBERTO DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 E LEIGH ST, RICHMOND, VA 23298-5004
(804) 828-9783
Mailing address
VCUHS GME ADMIN, 1200 EAST BROAD STREET, BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
0116037954
VA
Other
Enumeration date
04/11/2023
Last updated
06/15/2024
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