Dominick, Timothy S
Dominick, Timothy S is an individual health care provider with primary practice located at 111 Colchester Ave Wp2, 122Wp2, Burlington VT 05401-1473. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Dominick, Timothy S can be contacted via phone (802) 847-2415.Contact Information
Primary practice address
111 Colchester Ave Wp2, 122Wp2
Burlington VT 05401-1473
Phone: (802) 847-2415
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 042-0011085 | Vermont |
Profile Details
| NPI number | 1043283013 |
|---|---|
| LBN Legal business name | Dominick, Timothy S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Jan 12th, 2015 - about 10 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 | 1043283013 | NPPES |
| Vermont | MEDICAID | 1012295 | |
| Vermont | Other | 1043283013 |
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