Provider Demographics
NPI:1437156650
Name:MUDGE, DAWN M (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:M
Last Name:MUDGE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:5 LOWER RAGSDALE DR
Mailing Address - Street 2:100
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5817
Mailing Address - Country:US
Mailing Address - Phone:831-624-7070
Mailing Address - Fax:831-624-7050
Practice Address - Street 1:5 LOWER RAGSDALE DR
Practice Address - Street 2:100
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5817
Practice Address - Country:US
Practice Address - Phone:831-624-7070
Practice Address - Fax:831-624-7050
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2016-06-08
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Provider Licenses
StateLicense IDTaxonomies
CAG76261207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF56454Medicare UPIN