Provider Demographics
NPI:1831207471
Name:DAWDY, MICHAEL R (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:DAWDY
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:PO BOX 716
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66201-0716
Mailing Address - Country:US
Mailing Address - Phone:913-791-4357
Mailing Address - Fax:913-791-4435
Practice Address - Street 1:20333 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5350
Practice Address - Country:US
Practice Address - Phone:913-791-4357
Practice Address - Fax:913-791-4435
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-28089207P00000X
KS0428089207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103527OtherUHC
KS26758059OtherBCBSKC
KS100364160BMedicaid
MO1831207471Medicaid
26758029OtherBCBSKC
KS930113107OtherRR MEDICARE
KS100364160CMedicaid
KS7846200OtherAETNA
KSK54A365Medicare PIN
KS7846200OtherAETNA
26758029OtherBCBSKC