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Organization

M SHANE DAWSON MD PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW S DAWSON MD (MEDICAL DOCTOR)
(212) 548-3267
Entity
Organization

Contact information

Practice address
122 E 76TH ST OFC 1B, NEW YORK, NY 10021-2833
(212) 548-3267
Mailing address
122 E 76TH ST OFC 1B, NEW YORK, NY 10021-2833

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225166
LICENSE
NY
Enumeration date
10/08/2018
Last updated
10/08/2018
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