Provider Demographics
NPI:1245275502
Name:DAWSON, PHILIP AJ (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:AJ
Last Name:DAWSON
Suffix:
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 1:9606 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-6027
Mailing Address - Country:US
Mailing Address - Phone:804-740-6171
Mailing Address - Fax:804-741-3105
Practice Address - Street 1:9606 PATTERSON AVE
Practice Address - Street 2:PEDIATRICS
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-6027
Practice Address - Country:US
Practice Address - Phone:804-740-6171
Practice Address - Fax:804-741-3105
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101044138208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics