IndividualActive
Teresa Didomenico, PA-C
NPI 1114037207 · Physician Assistant · Munising, MI
Provider details
- NPI number
- 1114037207
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 5601002779 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1504 Sand Point Road
Munising, MI 49862-1406
Phone: (906) 387-4220
Fax: (906) 387-5449
Street-level locationGet directions
Mailing address
Po Box 201
Eben Junction, MI 49825-0201
Registry dates
- Enumerated
- 2006-08-30
- Last updated
- 2009-02-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.