Healthcare Provider Details

I. General information

NPI: 1205260700
Provider Name (Legal Business Name): KONRAD L DAWSON, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2013
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 IRVING ST NW #2400N
WASHINGTON DC
20010-2927
US

IV. Provider business mailing address

106 IRVING ST NW #2400N
WASHINGTON DC
20010-2927
US

V. Phone/Fax

Practice location:
  • Phone: 202-726-1000
  • Fax: 202-726-1601
Mailing address:
  • Phone: 202-726-1000
  • Fax: 202-726-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD25996
License Number StateDC

VIII. Authorized Official

Name: DR. KONRAD L DAWSON
Title or Position: PRESIDENT, CEO
Credential: M.D.
Phone: 202-726-1000