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Individual

DR. WILLIAM F. DOMINGUEZ

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1234
(505) 841-1956
Mailing address
1720 LOUISIANA BLVD NE, STE 401, ALBUQUERQUE, NM 87110-7020
(505) 260-4300
(505) 260-4338

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
93-39
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07355
NM
05
14580
NM
05
30404053
CO
05
340620
AZ
01
NM009C60
BLUE CROSS BLUE SHEILD
NM
Enumeration date
05/24/2005
Last updated
07/09/2007
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