Provider Demographics
NPI:1942275391
Name:TOEDT, DOMINIQUE MARIE (MD)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:MARIE
Last Name:TOEDT
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 1:1100 TUNNEL RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-2576
Mailing Address - Country:US
Mailing Address - Phone:828-369-1781
Mailing Address - Fax:
Practice Address - Street 1:647 WAYAH ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-3390
Practice Address - Country:US
Practice Address - Phone:828-369-1781
Practice Address - Fax:301-400-0618
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2000-01003207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC127NOOtherBCBS
NC127NOOtherBCBS
NC127NOOtherBCBS
NC8TA088Medicare ID - Type Unspecified