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Edgar Antonio Domenech
Student in an Organized Health Care Education/Training Program in Fayetteville, North Carolina
NPI 1770191629

Edgar Antonio Domenech is a Student in an Organized Health Care Education/Training Program based in Fayetteville, NC. Edgar Antonio Domenech practices in Fayetteville, NC. The NPI Number for Edgar Antonio Domenech is 1770191629 and holds a License No. (North Carolina).

The current practice location address for Edgar Antonio Domenech is 1638 Owen Drive, Fayetteville, NC and can be reached out via phone at 910-615-4000.

Location: 1638 Owen Drive, Fayetteville, NC, 28304
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770191629
Provider Name
Edgar Antonio Domenech
Credential
Provider Entity Type
Individual
Gender
Male
Address
1638 Owen Drive, Fayetteville, NC, 28304
Phone Number
910-615-4000
Fax Number
Provider Enumeration Date
07/16/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1638 Owen Drive
City
Fayetteville
State
North Carolina
Zip
28304
Phone Number
910-615-4000
Fax Number
person
Provider Business Mailing Address Details
Address
1638 Owen Drive
City
Fayetteville
State
North Carolina
Zip
28304
Phone Number
910-615-4000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
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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