Individual
DR. DIANE DICKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 FORE ST, PORTLAND, ME 04101-4879
(207) 808-0080
Mailing address
100 FORE ST, PORTLAND, ME 04101-4879
(207) 808-0080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G69727
CA
207Q00000X
Family Medicine Physician
Primary
MD25688
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G697270
—
CA
Enumeration date
06/15/2006
Last updated
04/27/2026
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