Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D0071691 | MD |
N | 207N00000X | Dermatologist | MD430963 | PA |
NPI | 1033252390 |
---|---|
Provider Name | Marianne E Dawn |
First Address | Glen Burnie, MD 21061-4998 |
Second Address | Glen Burnie, MD 21061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 23/09/2011 |