| NPI Details | |
|---|---|
| NPI | 1053396754 |
| Gender | Male |
| Enumeration Date | 12/14/2005 |
| Last Updated | 06/20/2013 |
| Entity Type | Individual |
| Active | Over 12 years ago |
| Practice Location | |
|---|---|
| 4885 OLENTANGY RIVER RD SUITE 2-10 COLUMBUS OH, 43214-1926, US |
|
| Phone | (614) 267-7878 |
| Fax | (614) 267-7077 |
| Business Location | |
|---|---|
| 4885 OLENTANGY RIVER RD SUITE 2-10 COLUMBUS OH, 43214-1926, US |
|
| Phone | (614) 267-7878 |
| Fax | (614) 267-7077 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 208000000X |
| License State | Ohio |
| License Number | 35-07-5037 |
| Remove 1053396754 NPI Number | |
According to our database, Kevin M. Dickerson M.D. NPI is 1053396754, taxonomy code is 208000000X and license number is 35-07-5037, license state is located at Ohio. Kevin M. Dickerson M.D. physically located at 4885 Olentangy River Rd, Columbus OH, 43214-1926. NPI Number Kevin M. Dickerson M.D. has the Individual type.
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1053396754 NPI number is provided on an as is basis without warranty of any kind. 1053396754 is maintained by the National Plan & Provider Enumeration System. The contents of Kevin M. Dickerson M.D. are for informational purposes only.
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