Provider Demographics
NPI:1538693437
Name:TOSI, DOMINIQUE M (MD)
Entity Type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:M
Last Name:TOSI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E UNIVERSITY PKWY
Mailing Address - Street 2:DEPT OF MEDICINE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2829
Mailing Address - Country:US
Mailing Address - Phone:410-554-2284
Mailing Address - Fax:410-554-2184
Practice Address - Street 1:201 E UNIVERSITY PKWY
Practice Address - Street 2:DEPT OF MEDICINE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2829
Practice Address - Country:US
Practice Address - Phone:410-554-2284
Practice Address - Fax:410-554-2184
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program