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
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
03/20/2025
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