Provider Demographics
NPI:1326412149
Name:DAWNS FAMILY PRACTICE
Entity Type:Organization
Organization Name:DAWNS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED NURSE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:WOLFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-777-9393
Mailing Address - Street 1:517 E OLDTOWN RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-3687
Mailing Address - Country:US
Mailing Address - Phone:301-777-9393
Mailing Address - Fax:301-777-9066
Practice Address - Street 1:517 E OLDTOWN RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-3687
Practice Address - Country:US
Practice Address - Phone:301-777-9393
Practice Address - Fax:301-777-9066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty