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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Monique Franchelle Dawkins
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- Donya Wallace Counseling &Consulting LLC
- Ranada Dozier York
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- Samuel Edward Drucker
All providers in Kingstree, SC · Internal Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2018. 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.