Individual
DR. JENNIFER DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2100 ERWIN RD, DURHAM, NC 27705-3941
(919) 684-8111
Mailing address
PO BOX 63362, CHARLOTTE, NC 28263-3362
(919) 684-8111
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
201201649
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/15/2008
Last updated
08/20/2013
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