Doctor Name: | DR. BRIAN DAWSON |
NPI Number: | 1063763522 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DPM |
License Number: | 65 006511 |
Business Practice Address: | 74 Amsterdam Rd Smithtown, NY - 117873122 |
Business Phone Number: | 6469184393 |
Business Fax Number: | |
Mailing Address: | 74 Amsterdam Rd, SMITHTOWN |
State: | NY |
Postal Code: | 117873122 |
Phone Number: | 6469184393 |
Fax Number: | |
NPI Enumeration Date: | 09/25/2012 |
NPI Last Update Date: | 09/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0000X |
License Number: | 65 006511 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Sports Medicine |
Taxonomy Definition: |