Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 247621 | MA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 255399 | NY |
NPI | 1184750820 |
---|---|
Provider Name | Courtney Dawson |
First Address | Boston, MA 02115-6110 |
Second Address | Dedham, MA 02026-6146 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 23/07/2015 |