Healthcare Provider Details

I. General information

NPI: 1902912843
Provider Name (Legal Business Name): DAWN M RICHARDSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 02/15/2023
Certification Date: 02/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

IV. Provider business mailing address

311 ROUTE 108
SOMERSWORTH NH
03878-1522
US

V. Phone/Fax

Practice location:
  • Phone: 603-749-2346
  • Fax: 603-953-0066
Mailing address:
  • Phone: 603-749-2346
  • Fax: 603-953-0066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number14094
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number74773
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: