Individual
DERI-ANN ROSHELLE DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7700 GERMANTOWN AVE, PHILADELPHIA, PA 19118-3549
(215) 247-1172
Mailing address
3401 CIVIC CENTER BLVD RM 5, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2022-00569
NC
208000000X
Pediatrics Physician
Primary
MD464419
PA
208000000X
Pediatrics Physician
MT208403
PA
Other
Enumeration date
06/04/2015
Last updated
03/01/2024
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