Individual
EDUARDO DE JESUS PINO DOMENECH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1638 OWEN DR, FAYETTEVILLE, NC 28304-3424
(910) 615-7392
(910) 615-7633
Mailing address
29 MEADOW FARM APT 6, NORTH CHILI, NY 14514-1370
(585) 642-2032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2026-03521
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2026-03521
NC
207RN0300X
Nephrology Physician
2026-03521
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2020
Last updated
07/29/2026
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