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General NPI Number Information
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NPI Number | 1326001447
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Entity Type | Individual
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Provider Name | LARRY J DASHOW MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 308 S BENNETT ST
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City | BURGAW
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State | NC
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Zip | 28425-5048
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Country | US
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Telephone | 910-259-8001
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Fax | 910-259-8003
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Provider Business Mailing Address
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Address Line | PO BOX 219
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City | BURGAW
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State | NC
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Zip | 28425-0219
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Country | US
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Telephone | 910-259-8001
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Fax | 910-259-8003
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | NC
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