Individual
DR. WILLIAM DICKIESON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1213 MASON ST, DEARBORN, MI 48124-2841
(313) 561-2446
Mailing address
1213 MASON ST, DEARBORN, MI 48124-2841
(313) 561-2446
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
001040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2120106
—
MI
01
—
WD001040
BLUE CROSS LICENSE
MI
Enumeration date
05/03/2006
Last updated
07/09/2007
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