Healthcare Provider Details

I. General information

NPI: 1558437442
Provider Name (Legal Business Name): MELANIE ERIN DAWSON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2406 BLUE RIDGE RD JEFFERS, MANN, ARTMAN PEDIATRICS, SUITE 100
RALEIGH NC
27607
US

IV. Provider business mailing address

6308 ROLESVILLE SADDLE DRIVE
ROLESVILLE NC
27571
US

V. Phone/Fax

Practice location:
  • Phone: 919-786-5001
  • Fax: 909-786-5051
Mailing address:
  • Phone: 919-786-5001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1000215
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: