Individual
DR. JOHN D DICKENS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH, SFHM
Contact information
Practice address
300 MAIN ST, LEWISTON, ME 04240-7007
(207) 795-0111
Mailing address
300 MAIN ST, LEWISTON, ME 04240-7027
(207) 795-0111
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
016935
ME
207R00000X
Internal Medicine Physician
DR.0064553
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016535
STSTE OF MAINE LICENSE
ME
Enumeration date
01/12/2006
Last updated
10/08/2020
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