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General NPI Number Information
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NPI Number | 1568643906
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Entity Type | Organization
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Legal Business Name | DAWN M. GRETZ D P M P A
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 1405 MADISON PARK DR
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City | GLEN BURNIE
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State | MD
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Zip | 21061-5627
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Country | US
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Telephone | 410-761-1666
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Fax | 410-768-5809
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Provider Business Mailing Address
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Address Line | 1405 MADISON PARK DR
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City | GLEN BURNIE
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State | MD
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Zip | 21061-5627
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Country | US
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Telephone | 410-761-1666
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Fax | 410-768-5809
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DAWN MARIE GRETZ
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Credential | DPM
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Telephone | 410-761-1666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 01219
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License Number State | MD
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