Healthcare Provider Details

I. General information

NPI: 1104353028
Provider Name (Legal Business Name): REBECCA DAWSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REBECCA FRAID DO

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

698 MULLICA HILL RD STE 320
MULLICA HILL NJ
08062-4453
US

IV. Provider business mailing address

134 BRIDGETON PIKE STE C
MULLICA HILL NJ
08062-2616
US

V. Phone/Fax

Practice location:
  • Phone: 856-508-3706
  • Fax: 856-221-4211
Mailing address:
  • Phone: 856-507-2783
  • Fax: 856-221-4138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number25MB10634100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: