# DR. ANTONETTE CONSUELO ACOSTA-DICKSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487625232
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 2003017244 | MO | Yes |

## Other

- **Enumeration date:** 01/30/2006
- **Last updated:** 02/20/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 33205014 | BCBS OF KC INDIVIDUAL \# | — |
| 01 | — | P00134132 | RAILROAD MEDICARE | — |