Healthcare Provider Details

I. General information

NPI: 1457342404
Provider Name (Legal Business Name): SHARON R DAWSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1669 ROUTE 65
ELLWOOD CITY PA
16117-5217
US

IV. Provider business mailing address

1669 ROUTE 65
ELLWOOD CITY PA
16117-5217
US

V. Phone/Fax

Practice location:
  • Phone: 724-773-8388
  • Fax:
Mailing address:
  • Phone: 724-773-8388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD417520
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: