Individual
DR. PAUL C DOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 TOWN CENTER PARKWAY, RESTON HOSPITAL CENTER, RESTON, VA 20190
(703) 471-0919
(703) 742-9081
Mailing address
PO BOX 2757, RESTON, VA 20195
(703) 471-0919
(703) 742-9081
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101054357
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005717213
—
VA
01
—
050082174
RAILROAD MEDICARE
—
01
—
173386
ANTHEM
—
Enumeration date
01/03/2006
Last updated
04/24/2020
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