Provider Demographics
NPI:1255682415
Name:O'REILLY, DAWN MARIE DELO (PHD, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:DAWN MARIE
Middle Name:DELO
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:PHD, PA-C
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Mailing Address - Street 1:PO BOX 751803
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1803
Mailing Address - Country:US
Mailing Address - Phone:336-277-2000
Mailing Address - Fax:336-277-2050
Practice Address - Street 1:186 KIMEL PARK DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-277-2000
Practice Address - Fax:336-277-2050
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2020-10-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-03658363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant