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General NPI Number Information
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NPI Number | 1740755685
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Entity Type | Organization
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Legal Business Name | M SHANE DAWSON MD PLLC
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Dates
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Enumeration Date | 10/08/2018
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Last Update Date | 10/08/2018
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Provider Practice Location Address
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Address Line | 122 E 76TH ST OFC 1B
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City | NEW YORK
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State | NY
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Zip | 10021-2833
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Country | US
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Telephone | 212-548-3267
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Fax |
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Provider Business Mailing Address
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Address Line | 122 E 76TH ST OFC 1B
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City | NEW YORK
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State | NY
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Zip | 10021-2833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DOCTOR
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Name | MATTHEW S DAWSON
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Credential | MD
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Telephone | 212-548-3267
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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