Provider Demographics
NPI:1407176282
Name:DAWS, SNOW BRENNER (MD)
Entity Type:Individual
Prefix:
First Name:SNOW
Middle Name:BRENNER
Last Name:DAWS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:SNOW
Other - Last Name:BRENNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:336-718-7950
Mailing Address - Fax:916-703-5074
Practice Address - Street 1:1730 KERNERSVILLE MEDICAL PKWY STE 204
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-7198
Practice Address - Country:US
Practice Address - Phone:336-277-4460
Practice Address - Fax:336-718-7989
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15825207X00000X, 207XX0004X
390200000X
NC2015-00405207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1407176282Medicaid
NVV110843Medicare PIN