Provider Demographics
NPI:1205846722
Name:PEKAREK, DAWN MARIE (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:PEKAREK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5761 S. FORT APACE RD.
Mailing Address - Street 2:BLDG. 8
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-5506
Mailing Address - Country:US
Mailing Address - Phone:702-341-6610
Mailing Address - Fax:
Practice Address - Street 1:5761 S. FORT APACE RD.
Practice Address - Street 2:BLDG. 8
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-5506
Practice Address - Country:US
Practice Address - Phone:702-341-6610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC132839207VM0101X
OH35093017207VM0101X
LA304218207VM0101X
NV21423207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL00932152Medicaid
AL009932153Medicaid
AL051530368OtherBCBS
AL051530370OtherBCBS
AL009932151Medicaid
051530360OtherBCBS
051530360OtherBCBS
AL00932152Medicaid