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Organization
ALBERT M. DICKSON MD
Active
Organization
ALBERT M. DICKSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY OTTO (SECRETARY)
(757) 460-5959
Entity
Organization
Contact information
Practice address
1020 INDEPENDENCE BLVD, STE 104, VIRGINIA BEACH, VA 23455-5500
(757) 460-5959
(757) 460-9873
Mailing address
1020 INDEPENDENCE BLVD, STE 104, VIRGINIA BEACH, VA 23455-5500
(757) 460-5959
(757) 460-9873
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101014144
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005605440
—
VA
01
—
011897313
MEDICARE
—
01
—
033677
BCBS
VA
01
—
31203
OPTIMA
—
Enumeration date
07/03/2008
Last updated
07/03/2008
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