Individual
DR. DAWN MIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2512 HURST DR, STE 120, MATTOON, IL 61938
(217) 258-5900
(217) 258-5904
Mailing address
611 W PARK ST, BWPC, URBANA, IL 61801
(217) 383-6941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036091488
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036091488
—
IL
Enumeration date
08/12/2006
Last updated
08/06/2016
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