Provider Demographics
NPI:1790776961
Name:DAWSON, IEON LLOYD (MD,FACC)
Entity Type:Individual
Prefix:DR
First Name:IEON
Middle Name:LLOYD
Last Name:DAWSON
Suffix:
Gender:M
Credentials:MD,FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3786
Mailing Address - Street 2:
Mailing Address - City:CROFTON
Mailing Address - State:MD
Mailing Address - Zip Code:21114-3786
Mailing Address - Country:US
Mailing Address - Phone:301-877-4933
Mailing Address - Fax:301-877-6963
Practice Address - Street 1:7700 OLD BRANCH AVE
Practice Address - Street 2:SUITE B 205
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-1628
Practice Address - Country:US
Practice Address - Phone:301-877-4933
Practice Address - Fax:301-877-6963
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0047553207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02607H01Medicare PIN
MDG01430I01Medicare PIN
MDG26606Medicare UPIN