Basic Information
Provider Information
NPI: 1154738326
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DAWLEY
FirstName: TROY
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
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Mailing Information
Address1: 225 BALDWIN AVE
Address2:  
City: CHARLOTTE
State: NC
PostalCode: 282043109
CountryCode: US
TelephoneNumber: 7043761605
FaxNumber:  
Practice Location
Address1: 1130 N CHURCH ST STE 200
Address2:  
City: GREENSBORO
State: NC
PostalCode: 274011041
CountryCode: US
TelephoneNumber: 3362724578
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/18/2014
LastUpdateDate: 11/23/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/23/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207T00000X5315066356MIN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000X5101021265MIN Allopathic & Osteopathic PhysiciansNeurological Surgery 
207T00000X2020-04822NCY Allopathic & Osteopathic PhysiciansNeurological Surgery 

No ID Information.


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