MEDICARE: DR. DAWN MAURINE CARDWELL M.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	208000000X	Pediatrics Physician	G200163	CA
2	208000000X	Pediatrics Physician	74947	GA

General Provider Information

NPI Number	:	1649236407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAWN MAURINE CARDWELL M.D.

Provider Business Mailing Address
First Line	:	200 CRESCENT CENTER PKWY
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-7047
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 CRESCENT CENTER PKWY
Second Line	:
City	:	TUCKER
State	:	GA
Zip	:	30084-7047
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:

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

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	09/25/2025

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