Mr. Michael Douglas Dickens
Pediatrician
1011 E Jefferson St
Charlottesville
, Virginia 22902-5354
Mr. Michael Douglas Dickens
Pediatrician
1011 E Jefferson St
Charlottesville
, Virginia 22902-5354
(434) 973-8493
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About
Features
Specialties
- Pediatrician
Languages spoken
- English
Location
First Address
- Mr. Michael Douglas Dickens
- 103 Kerry Ln
- Charlottesville, VA
- Zip : 22901-2924
- Phone : (434) 973-8493
Second Address
- Mr. Michael Douglas Dickens
- 1011 E Jefferson St
- Charlottesville, VA
- Zip : 22902-5354
- Fax : (434) 296-1036
- Phone : (434) 296-9161
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | 0101023851 | VA |
National Provider Identifier
| NPI | 1003893942 |
|---|---|
| Provider Name | Mr. Michael Douglas Dickens |
| First Address | Charlottesville, VA 22901-2924 |
| Second Address | Charlottesville, VA 22902-5354 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/12/2005 |
| Last Update Date | 29/09/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 006725791 | (05) | VA |
| 010714 | CIGNA (01) | VA |
| 12062000003 | SOUTHERN HEALTH (01) | VA |
| 267071 | MAMSI/ALLIANCE (01) | VA |
| 333839 | ANTHEM (01) | VA |
| 42720 | VETRI (01) | VA |
| B05443 | (02) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.