Healthcare Provider Details

I. General information

NPI: 1407206717
Provider Name (Legal Business Name): ERIN G DAWSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS ERIN G ANDRADE

II. Dates (important events)

Enumeration Date: 06/16/2016
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

51 N 39TH ST
PHILADELPHIA PA
19104-2640
US

V. Phone/Fax

Practice location:
  • Phone: 215-349-8310
  • Fax: 215-893-7270
Mailing address:
  • Phone: 215-662-7320
  • Fax: 215-243-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD482434
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: