Individual
NATALIE DOMINGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 15TH ST, AUGUSTA, GA 30912-3102
(706) 721-0211
Mailing address
1459 LANEY WALKER BLVD, AUGUSTA, GA 30912-0002
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
16267
GA
Other
Enumeration date
05/13/2024
Last updated
05/13/2024
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