Provider Demographics
NPI:1952350571
Name:DAWIS, ELVIRA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVIRA
Middle Name:M
Last Name:DAWIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3785 BAY RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-2433
Mailing Address - Country:US
Mailing Address - Phone:989-791-2455
Mailing Address - Fax:989-791-1392
Practice Address - Street 1:144 N FROST DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638
Practice Address - Country:US
Practice Address - Phone:989-790-5053
Practice Address - Fax:989-790-6426
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010358332080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2794532Medicaid
MI2794532Medicaid