MEDICARE: DR. STEVEN C DAWDY PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC2200X	Clinical Child & Adolescent Psychologist	363	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	23165	OTHER	IA	BC/BS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144264623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN C DAWDY PH.D.

Provider Business Mailing Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 349
City	:	CLIVE
State	:	IA
Zip	:	50325-7007
Country	:	US
Telephone Number	:	515-224-7233
Fax Number	:	515-224-0937

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 349
City	:	CLIVE
State	:	IA
Zip	:	50325-7007
Country	:	US
Telephone Number	:	515-224-7233
Fax Number	:	515-224-0937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/08/2007

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