Individual
DR. CARLOS B DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1970 TAMARACK RD, NEWARK, OH 43055-1363
(740) 344-2452
(740) 344-7305
Mailing address
8415 CLIFFTHORNE WAY, COLUMBUS, OH 43235-8410
(614) 505-0482
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35089303
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35089303
OHIO STATE MEDICAL LICENS
OH
Enumeration date
03/09/2007
Last updated
07/08/2007
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