Individual
MS. MICHELLE VICTORIA- DOMINIQUE HARVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
203 SALISBURY ST, WADESBORO, NC 28170-2155
(704) 694-6700
(704) 695-1227
Mailing address
203 SALISBURY ST, WADESBORO, NC 28170-2155
(704) 694-6700
(704) 695-1227
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-11821
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-11821
MEDICAL LICENSE
NC
Enumeration date
12/01/2021
Last updated
06/19/2023
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