Provider Demographics
NPI:1699407056
Name:KNIGHT, DOMINQUE J (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DOMINQUE
Middle Name:J
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6388 TIVOLI PL APT A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23605-2041
Mailing Address - Country:US
Mailing Address - Phone:804-824-6034
Mailing Address - Fax:
Practice Address - Street 1:5210 OAKLAWN BLVD
Practice Address - Street 2:
Practice Address - City:NORTH PRINCE GEORGE
Practice Address - State:VA
Practice Address - Zip Code:23860-7336
Practice Address - Country:US
Practice Address - Phone:804-458-8688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist