Dominguez, Mario L
Dominguez, Mario L is an individual health care provider with primary practice located at 1690 Main St Suite 4, South Weymouth MA 02190-1279. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Dominguez, Mario L can be contacted via phone (781) 337-8688.Contact Information
Primary practice address
1690 Main St Suite 4
South Weymouth MA 02190-1279
Phone: (781) 337-8688
Fax: (781) 337-8754
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 151294 | Massachusetts |
Profile Details
| NPI number | 1609807874 |
|---|---|
| LBN Legal business name | Dominguez, Mario L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2006 |
| Last updated | Aug 4th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609807874 | NPPES |
| Massachusetts | Other | 151274 | TAHP |
| Massachusetts | Other | BX6466 | TAHP |
| Massachusetts | Other | J17080 | TAHP |
| Massachusetts | MEDICAID | 3153517 | TAHP |
| Massachusetts | Other | 71156 | TAHP |
Popular Providers
-
Kapoor-Mohimen, Bonu
90 Libbey Industrial Pkwy , Weymouth MA 02189-3129 -
Roberts, Stephen
55 Fogg Rd , Weymouth MA 02190 -
Gustilo, Mary Catherine
541 Main St Suite 301, South Weymouth MA 02190-1868 -
Claybourne, Johvonne Michelle
541 Main St 414 , South Weymouth MA 02190-1889 -
Liu, Gerald
90 Libbey Industrial Pkwy Ste 106, Weymouth MA 02189-3129 -
Lannutti, Kelly
55 Fogg Rd , Weymouth MA 02190-2432 -
Phan, An K
541 Main St Ste 400 , South Weymouth MA 02190-1889 -
Iser, Martin
795 Bridge Street , Weymouth MA 02191