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General NPI Number Information
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NPI Number | 1669769915
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Entity Type | Organization
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Legal Business Name | FRANCES DWYER, MD
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 1712 LINCOLNWAY W SUITE A
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City | OSCEOLA
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State | IN
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Zip | 46561-1933
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Country | US
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Telephone | 574-675-9630
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Fax | 574-675-9629
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Provider Business Mailing Address
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Address Line | 1712 LINCOLNWAY W SUITE A
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City | OSCEOLA
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State | IN
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Zip | 46561-1933
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Country | US
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Telephone | 574-675-9630
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Fax | 574-675-9629
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Authorized Official
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Title or Position | OWNER
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Name | FRANCES D. DWYER
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Credential | M.D.
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Telephone | 574-675-9630
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01030061A
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License Number State | IN
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