Individual
MARY K DOMINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-3442
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-3442
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
26119-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407895428
—
WI
Enumeration date
06/05/2006
Last updated
11/10/2020
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