Healthcare Provider Details

I. General information

NPI: 1578291175
Provider Name (Legal Business Name): MADELINE QUINN DAWSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2022
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11100 EUCLID AVE
CLEVELAND OH
44106-1716
US

IV. Provider business mailing address

2195 WOODWARD AVE
LAKEWOOD OH
44107-5732
US

V. Phone/Fax

Practice location:
  • Phone: 216-946-7331
  • Fax:
Mailing address:
  • Phone: 216-308-7516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberCNM07750
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: