Provider Demographics
NPI:1265419444
Name:MARTIN-HERRING, DAWN
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:MARTIN-HERRING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 W GROVER ST
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-3825
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 W GROVER ST
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-3825
Practice Address - Country:US
Practice Address - Phone:980-487-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200300257207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1265419444Medicaid
5521529OtherCIGNA
BM7224304OtherDEA
135FROtherBCBS
SCN0025AMedicaid
2113981OtherMAMSI
7243476OtherAETNA
NC89135FRMedicaid
C7562OtherMEDCOST
701229OtherUHC
3248131OtherAETNA US HEALTH
2113981OtherMAMSI
NCNCE370AMedicare PIN
7243476OtherAETNA
NC2018032Medicare PIN