Provider Demographics
NPI:1134299142
Name:DAWSON, ERIC GEOFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:GEOFFREY
Last Name:DAWSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6196 OXON HILL RD STE 310
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3134
Mailing Address - Country:US
Mailing Address - Phone:301-567-2850
Mailing Address - Fax:301-567-9600
Practice Address - Street 1:6196 OXON HILL RD STE 310
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3134
Practice Address - Country:US
Practice Address - Phone:301-567-2850
Practice Address - Fax:301-567-9600
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038865207X00000X
VA0101048501207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00B333E69Medicare ID - Type Unspecified
G57121Medicare UPIN