Individual
MR. GERALD F DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
113 GAINSBOROUGH SQ STE 400, CHESAPEAKE, VA 23320-1714
(757) 842-4499
(757) 842-4490
Mailing address
667 KINGSBOROUGH SQ STE 101, CHESAPEAKE, VA 23320-4999
(757) 842-4481
(757) 466-8017
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110000927
VA
363A00000X
Physician Assistant
PA102599
MA
363A00000X
Physician Assistant
PA219354
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10005129P
OPTIMA
VA
01
—
139178
BCBS
VA
05
—
1861478216
—
VA
01
—
P00318486
RR MEDICARE
VA
Enumeration date
12/19/2005
Last updated
05/19/2026
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