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General NPI Number Information
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NPI Number | 1245582659
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Entity Type | Individual
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Provider Name | TABITHA LYNN DABKOWSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/23/2015
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Provider Practice Location Address
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Address Line | 557 BROOKDALE DR EMERGENCY DEPARTMENT
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City | STATESVILLE
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State | NC
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Zip | 28677-4107
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Country | US
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Telephone | 508-415-3134
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Fax |
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Provider Business Mailing Address
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Address Line | 18571 VINEYARD POINT LN
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City | CORNELIUS
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State | NC
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Zip | 28031-7989
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Country | US
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Telephone | 508-415-3134
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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