Healthcare Provider Details

I. General information

NPI: 1265676779
Provider Name (Legal Business Name): CANDICE DAWES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2009
Last Update Date: 07/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 GOOD HOPE RD SE SE
WASHINGTON DC
20020-3011
US

IV. Provider business mailing address

2501 GOOD HOPE RD SE SE
WASHINGTON DC
20020-3011
US

V. Phone/Fax

Practice location:
  • Phone: 202-476-6900
  • Fax:
Mailing address:
  • Phone: 202-476-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD040542
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: