Individual
MR. MICHAEL A DOMINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
505 ELM ST NE, ALBUQUERQUE, NM 87102-2500
(505) 238-2027
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2008-0031
NM
Other
Enumeration date
07/07/2008
Last updated
08/05/2025
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