Healthcare Provider Details

I. General information

NPI: 1083524623
Provider Name (Legal Business Name): DOMINIQUE NEWTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 WEAVER DAIRY RD STE 150
CHAPEL HILL NC
27514-1870
US

IV. Provider business mailing address

1146 AMBER SHADOW DR
DURHAM NC
27703-6780
US

V. Phone/Fax

Practice location:
  • Phone: 984-974-7005
  • Fax: 984-974-9482
Mailing address:
  • Phone: 720-877-4287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: