Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | MN36788 | MN |
N | 207VG0400X | Gynecologist | 36788 | MN |
NPI | 1184767204 |
---|---|
Provider Name | Joan F Dawson |
First Address | Edina, MN 55435-4544 |
Second Address | Edina, MN 55435-4544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G39595 | (02) |