Raymond Henry Dominici Jr., MD

Individual provider Active NPI Internal Medicine Physician · Kingstree, SC

NPI 1356709299 · NPPES record last updated Feb 14, 2018

Key facts

NPI
1356709299
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
38972 (SC)
Practice address
520 Thurgood Marshall Hwy
Kingstree, SC 29556-4108
Phone
(843) 355-5628
Fax
(843) 355-6072
NPI assigned
Feb 6, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 38972 SC Yes

Addresses

Primary practice location

520 Thurgood Marshall Hwy
Kingstree, SC 29556-4108

Mailing address

360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414

Other providers in Kingstree, SC

All providers in Kingstree, SC · Internal Medicine Physician in South Carolina

Sources for this page

Verify at the official NPI Registry.