Provider Demographics
NPI:1235219569
Name:DAWN L. MACFARLAND, MD, INC.
Entity Type:Organization
Organization Name:DAWN L. MACFARLAND, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MACFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-523-5555
Mailing Address - Street 1:2674 5TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-1329
Mailing Address - Country:US
Mailing Address - Phone:304-523-5555
Mailing Address - Fax:304-523-2220
Practice Address - Street 1:2674 5TH AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1329
Practice Address - Country:US
Practice Address - Phone:304-523-5555
Practice Address - Fax:304-523-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV19790207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV6000072000Medicaid
OH2112118Medicaid
OH2112118Medicaid