Individual
DR. LARRY J DASHOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
308 S BENNETT ST, BURGAW, NC 28425-5048
(910) 259-8001
(910) 259-8003
Mailing address
PO BOX 219, BURGAW, NC 28425-0219
(910) 259-8001
(910) 259-8003
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13350
BCBS OF NC PROVIDER #
NC
05
—
8913350
—
NC
Enumeration date
04/10/2006
Last updated
07/08/2007
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