| Dr Jose E Dominguez, MD | |
|
6701 N Charles St, Towson, MD 21204-6808 | |
| (410) 296-4616 | |
| (410) 337-5068 |
| Full Name | Dr Jose E Dominguez |
|---|---|
| Gender | Male |
| Speciality | Anesthesiology |
| Experience | 37 Years |
| Location | 6701 N Charles St, Towson, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942201884 | NPI | - | NPPES |
| D0044736 | Other | MD | STATE LICENSE NUMBER |
| 171681600 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | D0044736 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Suburban Hospital | Bethesda, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Centra Medical Group Llc | 4789606088 | 681 |
| First Colonies Anesthesia Associates, Llc | 8426039744 | 312 |
| Entity Name | Centra Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649228966 PECOS PAC ID: 4789606088 Enrollment ID: O20051230000147 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jose E Dominguez, MD 1122 Kenilworth Dr, Ste 317, Towson, MD 21204-2146 Ph: (410) 296-4616 | Dr Jose E Dominguez, MD 6701 N Charles St, Towson, MD 21204-6808 Ph: (410) 296-4616 |
Dr. Lewis Hogge, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
Deondra Patrice-simmons Asike, M.D. Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 6701 N Charles St # 4226, Towson, MD 21204 Phone: 410-296-4616 | |
Aloise Diedrich, Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 443-849-2000 | |
Dr. John Yang, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 410-296-4616 Fax: 410-337-5068 | |
William D. Zeichner, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 6701 N Charles St, Towson, MD 21204 Phone: 512-574-5552 | |
Dr. Gary Michael Vita, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 7505 Osler Dr, Towson, MD 21204 Phone: 410-337-5337 | |
Theodore Grabow, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 8322 Bellona Ave, Suite 330, Towson, MD 21204 Phone: 410-825-6945 Fax: 410-825-8974 |