Healthcare Provider Details

I. General information

NPI: 1851560403
Provider Name (Legal Business Name): FRANK P DAWSON IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2008
Last Update Date: 10/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5009 HONEYGO CENTER DR SUITE 225
PERRY HALL MD
21128-9828
US

IV. Provider business mailing address

5009 HONEYGO CENTER DR SUITE 225
PERRY HALL MD
21128-9828
US

V. Phone/Fax

Practice location:
  • Phone: 443-725-2100
  • Fax: 443-725-2121
Mailing address:
  • Phone: 443-725-2100
  • Fax: 443-725-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD67299
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberD67299
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License NumberD67299
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: