# ALBERT M. DICKSON MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255594867
- **Authorized official:** MARY OTTO (SECRETARY)
- **Authorized official phone:** (757) 460-5959

## Contact information

- **Practice address:** 1020 INDEPENDENCE BLVD, STE 104, VIRGINIA BEACH, VA 23455-5500
- **Practice address phone:** (757) 460-5959
- **Practice address fax:** (757) 460-9873
- **Mailing address:** 1020 INDEPENDENCE BLVD, STE 104, VIRGINIA BEACH, VA 23455-5500
- **Mailing address phone:** (757) 460-5959
- **Mailing address fax:** (757) 460-9873

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 0101014144 | VA | Yes |

## Other

- **Enumeration date:** 07/03/2008
- **Last updated:** 07/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005605440 | — | VA |
| 01 | — | 011897313 | MEDICARE | — |
| 01 | — | 033677 | BCBS | VA |
| 01 | — | 31203 | OPTIMA | — |