Healthcare Provider Details

I. General information

NPI: 1952350571
Provider Name (Legal Business Name): ELVIRA M DAWIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 05/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N FROST DR SUITE 2
SAGINAW MI
48638
US

IV. Provider business mailing address

3785 BAY RD
SAGINAW MI
48603-2433
US

V. Phone/Fax

Practice location:
  • Phone: 989-790-5053
  • Fax: 989-790-6426
Mailing address:
  • Phone: 989-791-2455
  • Fax: 989-791-1392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4301035833
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: