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Individual

EDWARD PAUL DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M D

Contact information

Practice address
3545 OLENTANGY RIVER RD, SUITE 525, COLUMBUS, OH 43214-3907
(614) 261-1900
(614) 261-7538
Mailing address
2595 MARBLEVISTA BLVD, COLUMBUS, OH 43204-9012
(614) 261-1900
(614) 261-7538

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M2308
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2664620
OH
Enumeration date
05/04/2006
Last updated
04/30/2021
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