Individual provider · NPI-1

Dr. Dominic T. Haynesworth Sr., M.D.

Emergency Medicine · Cleveland, OH

NPI number1073550752
StatusActive
Last updated in NPPESAug 10, 2021

Details

NPI
1073550752
Entity type
Individual (NPI-1)
Name
Dr. Dominic T. Haynesworth Sr.
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Jun 1, 2006
Certification date
Aug 10, 2021
Last updated
Aug 10, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207P00000X Emergency Medicine46583OHYes
146D00000X Personal Emergency Response Attendant35046582OH

Practice location

2351 E 22nd St
Cleveland, OH 44115-3111

Phone 216-861-6200

Mailing address

3620 Langton Rd
Cleveland, OH 44121-1323

Other practice locations

13951 Terrace Rd
East Cleveland, OH 44112-4308

Phone 216-761-3300

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