Individual
DR. CHARLIE A. DICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9251 TWENTY MILE ROAD, PARKER, CO 80134
(970) 225-5000
Mailing address
4674 SNOW MESA DR, SUITE 140, FORT COLLINS, CO 80528
(970) 225-5000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32030
IA
207Q00000X
Family Medicine Physician
DR.0034346
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080114694
RAILROAD MEDICARE
IA
05
—
1157081
—
IA
05
—
1205832433
—
IA
01
—
40692
BLUE SHIELD OF IOWA
IA
Enumeration date
06/22/2005
Last updated
08/13/2024
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