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NPI Code Detail

MEDICARE: SAMUEL KANG-NIEN DAWN MD

MEDICARE: SAMUEL KANG-NIEN DAWN MD
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
12085R0202XDiagnostic Radiology PhysicianME172174FL
22085R0202XDiagnostic Radiology PhysicianA61175CA
32085B0100XBody Imaging PhysicianA61175CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295797322
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMUEL KANG-NIEN DAWN MD
Provider Business Mailing Address
First Line : 1602 AVENUE Q
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-4732
Country : US
Telephone Number : 650-766-0887
Fax Number : 650-249-5055
Provider Business Practice Location Address
First Line : 1602 AVENUE Q
Second Line :
City : LUBBOCK
State : TX
Zip : 79401-4732
Country : US
Telephone Number : 650-766-0887
Fax Number : 650-249-5055
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2006
Last Update Date : 12/30/2025

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