Healthcare Provider Details

I. General information

NPI: 1063439537
Provider Name (Legal Business Name): DAWN MANNING-WILLIAMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3031
US

IV. Provider business mailing address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3031
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4852
  • Fax:
Mailing address:
  • Phone: 404-616-4563
  • Fax: 404-616-9213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number033640
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: