Individual
DOMINIQUE RAULS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Mailing address
420 POLIFKA DR, SHAW AFB, SC 29152-5100
(803) 895-6356
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN268515
GA
Other
Enumeration date
10/31/2023
Last updated
01/30/2026
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