Individual
RACHEL ANNE DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
111 PROSPECT AVE STE 202A, KIRKWOOD, MO 63122-6067
(314) 394-2973
(785) 414-5373
Mailing address
111 PROSPECT AVE STE 202A, KIRKWOOD, MO 63122-6067
(314) 394-2973
(785) 414-5373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2012012812
MO
208000000X
Pediatrics Physician
2012012812
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174797427
—
MO
Enumeration date
04/17/2008
Last updated
11/20/2024
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