Individual
CHERYL J. DOMINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4848 S 76TH ST, SUITE 210, GREENFIELD, WI 53220-4361
(414) 282-7444
(414) 282-8221
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
43362
WI
208000000X
Pediatrics Physician
43362
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34192000
—
WI
01
—
P00975440
RR MEDICARE
WI
Enumeration date
08/26/2005
Last updated
12/01/2021
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