MEDICARE: DAVID DIXON DORWAY MD

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	208000000X	Pediatrics Physician	3582	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	CS01857	OTHER	NV	STATE PHARMACY
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3582	OTHER	NV	MEDICAL LICENSE

General Provider Information

NPI Number	:	1154323855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID DIXON DORWAY MD

Provider Business Mailing Address
First Line	:	PO BOX 1737
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89125-1737
Country	:	US
Telephone Number	:	702-671-6809
Fax Number	:	702-671-6883

Provider Business Practice Location Address
First Line	:	3150 N TENAYA WAY
Second Line	:	#260
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0443
Country	:	US
Telephone Number	:	702-870-2099
Fax Number	:	702-407-0266

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	03/07/2023

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Directions to “ DAVID DIXON DORWAY MD” Practice Location

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