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Contact Information

DOMINIC J MAXWELL, MD
15 CHURCH ST
VINEYARD HAVEN, MA02568
 Phone: 508-687-9592
 Fax: 508-687-9567
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for DOMINIC J MAXWELL · (Male)

NPI Number 1134178106
Status Active
Credentials MD
Entity Individual
Enumeration date 05/08/2006
Last updated 06/23/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • AL License # 00025983
  • AL Medicaid 009933454
  • AL Other 051530946 BC BS OF AL
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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