Albert T. Domingo Ms MD Inc
Organization Active NPI Specialist · Canton, OH
NPI 1164582631 · NPPES record last updated Oct 17, 2016
Key facts
- NPI
- 1164582631
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 49267 (OH)
- Legal business name
- ALBERT T. DOMINGO MS MD INC
- Practice address
- 3120 Parkway St NW
Suite a
Canton, OH 44708-3981 - Phone
- (330) 452-9460
- Fax
- (330) 452-9520
- NPI assigned
- Dec 12, 2006
- Organization subpart
- No
Authorized official
- Name
- Albert T. Domingo, MD
- Title
- President
- Phone
- (330) 452-9460
Practitioners 3
-
Fares Alqara, M.D.
-
Danielle S. Kiko, M.D.
-
Tracey K Peatross, M.D.
National Provider Directory
Locations
3120 Parkway St NW
Ste A
Canton, OH 44708
Phone (330) 452-9460
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 49267 | OH | Yes |
Addresses
Primary practice location
3120 Parkway St NW
Suite a
Canton, OH 44708-3981
Mailing address
3120 Parkway St NW
Suite a
Canton, OH 44708-3981
Phone (330) 452-9460
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0544370 | Medicaid | OH |
Other providers in Canton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.