Provider Demographics
NPI:1306629100
Name:DODSON, ANDREW CLEVELAND
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:CLEVELAND
Last Name:DODSON
Suffix:
Gender:M
Credentials:
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 1418
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28151-1418
Mailing Address - Country:US
Mailing Address - Phone:704-480-1882
Mailing Address - Fax:704-480-1832
Practice Address - Street 1:1610 E MARION ST STE 250
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4982
Practice Address - Country:US
Practice Address - Phone:704-480-1882
Practice Address - Fax:704-480-1832
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist