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General NPI Number Information
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NPI Number | 1720360332
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Entity Type | Individual
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Provider Name | MARK W DAWSON RPH
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Gender | Male
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Dates
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Enumeration Date | 09/09/2011
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Last Update Date | 05/11/2018
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Provider Practice Location Address
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Address Line | 710 SPRING ST
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City | PETOSKEY
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State | MI
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Zip | 49770-2851
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Country | US
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Telephone | 231-348-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1260 AJIJAAK AVE
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City | PETOSKEY
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State | MI
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Zip | 49770-8330
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Country | US
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Telephone | 231-242-1750
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Fax | 231-242-1755
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302410739
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License Number State | MI
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