Provider Demographics
NPI:1578565040
Name:DAWIS, MARIA AGNES C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA AGNES
Middle Name:C
Last Name:DAWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:61 DAVIS AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4401
Mailing Address - Country:US
Mailing Address - Phone:732-776-4271
Mailing Address - Fax:732-776-4867
Practice Address - Street 1:61 DAVIS AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4401
Practice Address - Country:US
Practice Address - Phone:732-776-4271
Practice Address - Fax:732-776-4867
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2017-01-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA084118002080P0208X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ135093UWHMedicare PIN