Provider Demographics
NPI:1548210982
Name:DAWSON, WILLIAM T JR (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:T
Last Name:DAWSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 DOUGHTY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5736
Mailing Address - Country:US
Mailing Address - Phone:843-577-6791
Mailing Address - Fax:843-577-0553
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5736
Practice Address - Country:US
Practice Address - Phone:843-577-6791
Practice Address - Fax:843-577-0553
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10586207RP1001X, 207RC0200X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC105861Medicaid
SCP00908555OtherRAILROAD MC ID - RHI
SC10477700OtherOWCP-WC PROVIDER #
SC827013747OtherRAILROAD MEDICARE PIN #
SCD90758Medicare UPIN
SC10477700OtherOWCP-WC PROVIDER #
SCP00908555OtherRAILROAD MC ID - RHI