Healthcare Provider Details

I. General information

NPI: 1669401204
Provider Name (Legal Business Name): MICHAEL ALLEN DAWSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 MERIDIAN MARKS RD NE SUITE 350
ATLANTA GA
30342-4763
US

IV. Provider business mailing address

5780 PEACHTREE DUNWOODY ROAD SUITE 300
ATLANTA GA
30342-1513
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-5196
  • Fax: 404-252-2414
Mailing address:
  • Phone: 404-303-1224
  • Fax: 404-303-1325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number051032
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: