Individual
DOMNIQUE S NEWALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 WOODRUFF CIR NE, ATLANTA, GA 30322-4607
(678) 362-2475
(678) 807-5414
Mailing address
2825 OAK LAWN AVE UNIT 192749, DALLAS, TX 75219-4688
(510) 683-9500
(877) 880-2039
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
81677
GA
2085N0904X
Nuclear Radiology Physician
81677
GA
2085R0202X
Diagnostic Radiology Physician
35.151641
OH
2085R0202X
Diagnostic Radiology Physician
Primary
91700
SC
Other
Enumeration date
03/22/2017
Last updated
04/23/2026
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