Provider Demographics
NPI:1407917644
Name:DAWKINS, STEPHEN A (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:A
Last Name:DAWKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CASCADE POINTE DR SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-8501
Mailing Address - Country:US
Mailing Address - Phone:404-761-4040
Mailing Address - Fax:404-761-4008
Practice Address - Street 1:535 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HAPEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30354-1603
Practice Address - Country:US
Practice Address - Phone:404-761-4040
Practice Address - Fax:404-761-4008
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0330662083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA033066OtherSTATE MEDICAL LICENSE
CAG87875OtherSTATE MEDICAL LICENSE
FLME73519OtherSTATE MEDICAL LICENSE
CAG87875OtherSTATE MEDICAL LICENSE