Healthcare Provider Details

I. General information

NPI: 1346282555
Provider Name (Legal Business Name): EUGENE SCOTT DAWSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7666 CHARLOTTE HWY SUITE 230
INDIAN LAND SC
29707-7000
US

IV. Provider business mailing address

7666 CHARLOTTE HWY STE 230
INDIAN LAND SC
29707-7000
US

V. Phone/Fax

Practice location:
  • Phone: 803-547-8800
  • Fax: 803-547-8822
Mailing address:
  • Phone: 803-547-8800
  • Fax: 803-547-8822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number477
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number9700525
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: