Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101262902 | VA |
N | 207X00000X | Orthopaedic Surgeon | MT195182 | PA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 0101262902 | VA |
NPI | 1700014198 |
---|---|
Provider Name | Dr. Crystal Meera Dickson |
First Address | Baltimore, MD 21279-0777 |
Second Address | Charlottesville, VA 22911-4669 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2009 |
Last Update Date | 13/12/2018 |