MEDICARE: DR. DOMINQUE J KNIGHT PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	0202220511	VA

General Provider Information

NPI Number	:	1699407056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOMINQUE J KNIGHT PHARM.D.

Provider Business Mailing Address
First Line	:	6388 TIVOLI PL APT A
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23605-2041
Country	:	US
Telephone Number	:	804-824-6034
Fax Number	:

Provider Business Practice Location Address
First Line	:	5210 OAKLAWN BLVD
Second Line	:
City	:	NORTH PRINCE GEORGE
State	:	VA
Zip	:	23860-7336
Country	:	US
Telephone Number	:	804-458-8688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2022
Last Update Date	:	06/25/2022

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