Individual
DR. ETOSHA D DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22045
WV
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
D61785
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005559001
—
MD
01
—
0056
CAREFIRST DC
—
01
—
0123302
EVERCARE
—
01
—
0442052
EVERCARE
—
01
—
093NER-896608-01
CAREFIRST BCBS OF MD
—
01
—
093NSE-896608-01
CAREFIRST BCBS OF MD
—
01
—
769698
BCBS
—
05
—
805701000
—
MD
01
—
89660801
BCBS MD
—
01
—
9676-0039
CAREFIRST BCBS OF DC
—
01
—
T016-0057
BCBS-DC
—
Enumeration date
04/01/2006
Last updated
04/21/2022
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