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Individual

DR. MATTHEW SHANE DAWSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
111 E 75TH ST OFC 1A, NEW YORK, NY 10021-2816
(212) 744-1100
(646) 688-5125
Mailing address
111 E 75TH ST OFC 1A, NEW YORK, NY 10021-2816
(212) 744-1100
(877) 732-3203

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
225166
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225166
LIC
NY
01
BD7909875
DEA
Enumeration date
09/13/2006
Last updated
07/16/2024
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