Individual provider · Type 1 NPI

Olivia Domingue, MD

Student in an Organized Health Care Education/Training Program · Providence, RI

NPI number 1063209294 Active

Practice location

593 Eddy St
Providence, RI 02903-4923

Call (401) 793-2695 Map

Fax (401) 444-4165

Specialties and licenses

TaxonomyCodeLicense
Pediatrics Physician 208000000XMD12345 (RI)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1063209294

Olivia Domingue, MD's National Provider Identifier is 1063209294, issued on Apr 22, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Providence, RI. The record was last updated on Apr 22, 2025.