Individual
MS. MICHELLE VICTORIA- DOMINIQUE HARVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2910 EAST FRANKLIN BLVD #1, GASTONIA, NC 28056-7225
(704) 648-0460
(855) 446-7146
Mailing address
2910 EAST FRANKLIN BLVD #1, GASTONIA, NC 28056
(704) 648-0460
(855) 446-7146
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-11821
NC
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
07/31/2026
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