Individual
DOMINIQUE FOULKES
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 CATON AVE, BALTIMORE, MD 21229-5201
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 827426, PHILADELPHIA, PA 19182-7426
(904) 805-1300
(904) 805-1302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D0060971
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60609101
BLUE CROSS
MD
Enumeration date
06/01/2006
Last updated
07/08/2007
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