Individual
DR. MICHELE DOMENICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
500 CADMUS LN STE 205, EASTON, MD 21601-4094
(410) 822-4553
Mailing address
200 BANNING ST, SUITE 310, DOVER, DE 19904-3485
(302) 674-0600
(302) 672-7144
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
C1-0006569
DE
207Q00000X
Family Medicine Physician
C1-0006569
DE
208600000X
Surgery Physician
Primary
D92021
MD
Other
Enumeration date
02/17/2006
Last updated
07/20/2021
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