MEDICARE: LAURA L DAWSON MAOM, DIPL.AC.

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	171100000X	Acupuncturist	U02298	MD
2	174H00000X	Health Educator	U02298	MD
3	1744R1102X	Research Study Specialist	U02298	MD
4	246Y00000X	Health Information Specialist/Technologist	U02298	MD
5	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	U02298	MD
6	133NN1002X	Nutrition Education Nutritionist	U02298	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016303	OTHER		NAT'L LICENSE-NCCAOM
2	1013971381	OTHER		NPI-FOR FOOD PHYSICS AND BODY DYNAMICS LLC, OWNED BY L DAWSON
3	U02298	OTHER	MD	ACUPUNCTURE LICENSING BOARD
4	621399	OTHER		CCR GOVERNMENT CONTRACTING CODIFICATION
5	51WY9	OTHER		CCR CAGE#

General Provider Information

NPI Number	:	1225108400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L DAWSON MAOM, DIPL.AC.

Provider Business Mailing Address
First Line	:	PO BOX 56
Second Line	:
City	:	CASTLE HAYNE
State	:	NC
Zip	:	28429-0056
Country	:	US
Telephone Number	:	910-777-7307
Fax Number	:

Provider Business Practice Location Address
First Line	:	2826 BELLWOOD AVE
Second Line	:
City	:	CASTLE HAYNE
State	:	NC
Zip	:	28429-6506
Country	:	US
Telephone Number	:	910-777-7307
Fax Number	:

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	06/01/2016

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