DAWSON STREET FAMILY PRACTICE P.A. NPI 1811141849

NPI Information

DAWSON STREET FAMILY PRACTICE P.A. is a medical physician assistant in Wilmington, NC. DAWSON STREET FAMILY PRACTICE P.A. NPI is 1811141849. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

608 DAWSON ST
WILMINGTON, NC
ZIP 28401-712
Phone: (910) 667-0471
Fax: (910) 667-0475

The provider's authorized official is Ronald Demas .
The authorized official title is Medical Director / Owner and has the following contact phone number (910) 667-0471.

The CLIA number assigned to this NPI record is 34D1094799 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/4/2008 and was last updated on 11/4/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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