MEDICARE: EUGENE SCOTT DAWSON D.O.

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	207RC0000X	Cardiovascular Disease Physician	477	SC
2	207RC0000X	Cardiovascular Disease Physician	9700525	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1055F	OTHER	NC	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346282555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EUGENE SCOTT DAWSON D.O.

Provider Business Mailing Address
First Line	:	7666 CHARLOTTE HWY
Second Line	:	STE 230
City	:	INDIAN LAND
State	:	SC
Zip	:	29707-7000
Country	:	US
Telephone Number	:	803-547-8800
Fax Number	:	803-547-8822

Provider Business Practice Location Address
First Line	:	7666 CHARLOTTE HWY
Second Line	:	SUITE 230
City	:	INDIAN LAND
State	:	SC
Zip	:	29707-7000
Country	:	US
Telephone Number	:	803-547-8800
Fax Number	:	803-547-8822

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	06/27/2019

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