Individual
DAVID C. DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UNM DEPARTMENT OF EMERGENCY MEDICINE MSC10, 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-5062
(505) 272-6503
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
89-183
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051219601
—
TX
05
—
1006670
—
VT
05
—
203890009
—
MO
05
—
272378
—
AZ
05
—
3-Z8389
—
UT
05
—
334049000
—
MN
05
—
7610976
—
NC
05
—
W0103
—
NM
05
—
XPY184813
—
CA
Enumeration date
10/13/2006
Last updated
09/09/2011
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