Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 716 | WI |
Y | 222Z00000X | Podiatrist | 716 | WI |
N | 213EP1101X | Primary Podiatric Medicine | 716 | WI |
N | 213EP1101X | Primary Podiatric Medicine | 816 | MN |
NPI | 1285639427 |
---|---|
Provider Name | David M Dawson |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601-5429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2005 |
Last Update Date | 02/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
43221100 | (05) | WI |
U57566 | (02) |