Provider Demographics
NPI:1932218203
Name:DAWSON, ROBERT E III (MPT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:DAWSON
Suffix:III
Gender:M
Credentials:MPT
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 13253
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4023
Mailing Address - Country:US
Mailing Address - Phone:410-749-4154
Mailing Address - Fax:410-860-9583
Practice Address - Street 1:600 GLEN AVE STE 203
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5250
Practice Address - Country:US
Practice Address - Phone:410-749-4154
Practice Address - Fax:410-860-9583
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21090225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21090OtherLICENSE #