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Individual
DAWN A FAIRLEY
Active
Individual
DAWN A FAIRLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2006023529
MO
207Q00000X
Family Medicine Physician
20A 7187
CA
207Q00000X
Family Medicine Physician
OS 9881
FL
207Q00000X
Family Medicine Physician
OS012469
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019478700001
—
PA
05
—
207348905
—
MO
01
—
961950085
MEDICARE ID - TYPE UNSPECIFIED
MO
Enumeration date
06/21/2006
Last updated
04/27/2012
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