Healthcare Provider Details

I. General information

NPI: 1629062641
Provider Name (Legal Business Name): DAWN E DE NEEF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 08/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 10TH AVE NE
HICKORY NC
28601-3834
US

IV. Provider business mailing address

304 10TH AVE NE
HICKORY NC
28601-3834
US

V. Phone/Fax

Practice location:
  • Phone: 828-322-2183
  • Fax: 828-322-2389
Mailing address:
  • Phone: 828-322-2183
  • Fax: 828-322-2389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number200300606
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: