Individual
ANGELA P DOMINIQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.P.M.
Contact information
Practice address
3524 DECATUR HWY, SUITE 301, FULTONDALE, AL 35068-1366
(205) 631-3699
(205) 631-7325
Mailing address
3524 DECATUR HWY, SUITE 301, FULTONDALE, AL 35068-1366
(205) 631-3699
(205) 631-7325
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
180
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000060837
—
AL
01
—
1536404
UMWA H&R FUNDS
AL
01
—
27-10123
UNITED HEALTHCARE
AL
01
—
480026565
RAILROAD MEDICARE
AL
01
—
510-60837
BLUE CROSS BLUE SHIELD AL
AL
01
—
U71228
VIVA HEALTH
AL
Enumeration date
08/22/2006
Last updated
06/27/2016
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