Provider Demographics
NPI:1346282555
Name:DAWSON, EUGENE SCOTT (DO)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:SCOTT
Last Name:DAWSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7666 CHARLOTTE HWY
Mailing Address - Street 2:STE 230
Mailing Address - City:INDIAN LAND
Mailing Address - State:SC
Mailing Address - Zip Code:29707-7000
Mailing Address - Country:US
Mailing Address - Phone:803-547-8800
Mailing Address - Fax:803-547-8822
Practice Address - Street 1:7666 CHARLOTTE HWY
Practice Address - Street 2:SUITE 230
Practice Address - City:INDIAN LAND
Practice Address - State:SC
Practice Address - Zip Code:29707-7000
Practice Address - Country:US
Practice Address - Phone:803-547-8800
Practice Address - Fax:803-547-8822
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC477207RC0000X
NC9700525207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1055FOtherBCBS
SCT00870Medicaid
NC891055FMedicaid
NC2237767HMedicare PIN
NC2237767Medicare PIN
SCG455187772Medicare PIN
SCT00870Medicaid
NC891055FMedicaid
SCG455185332Medicare PIN
NCG45518Medicare UPIN
SCG455188186Medicare PIN