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NPI Code Detail

MEDICARE: DR. TAMIKA S DAWSON MD

MEDICARE: DR. TAMIKA S DAWSON 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
1207Q00000XFamily Medicine Physician01064047AIN

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 : 1942400734
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TAMIKA S DAWSON MD
Provider Business Mailing Address
First Line : 250 N SHADELAND AVE
Second Line : STE 130 - PROVIDER ENROLLMENT
City : INDIANAPOLIS
State : IN
Zip : 46219-4959
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 201 N ILLINOIS ST STE 110
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46204-4293
Country : US
Telephone Number : 317-948-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2007
Last Update Date : 06/20/2018

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