Dawson, Derek J

Dawson, Derek J is an sole proprietor health care provider with primary practice located at 8256 Hohman Ave , Munster IN 46321-1516. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Dawson, Derek J can be contacted via phone (219) 836-2770.

Contact Information

Primary practice address
8256 Hohman Ave Munster IN 46321-1516
Fax: (219) 836-0438
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 01033635A Indiana

Profile Details

NPI number 1013992411
LBN Legal business name Dawson, Derek J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 8th, 2005
Last updated Sep 6th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013992411 NPPES
Indiana MEDICAID 100215670

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