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General NPI Number Information
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NPI Number | 1194885582
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Entity Type | Organization
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Legal Business Name | DAWSON DERMATOLOGY, LLC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 1380 LUSITANA ST SUITE 412
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City | HONOLULU
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State | HI
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Zip | 96813-2421
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Country | US
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Telephone | 808-599-3780
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Fax | 808-538-1672
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Provider Business Mailing Address
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Address Line | 1380 LUSITANA ST SUITE 412
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City | HONOLULU
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State | HI
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Zip | 96813-2421
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Country | US
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Telephone | 808-599-3780
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Fax | 808-538-1672
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Authorized Official
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Title or Position | OWNER/SOLE MEMBER
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Name | DR. KEVIN L DAWSON
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Credential | M.D.
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Telephone | 808-599-3780
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD1577
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD12990
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License Number State | HI
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