Individual
DR. TASHA BROOKS DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
304 E LEIGH ST, RICHMOND, VA 23219-1410
(804) 225-7148
(804) 225-7159
Mailing address
1510 N 28TH ST, STE 300, RICHMOND, VA 23223-5332
(804) 225-7177
(804) 225-7176
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101237311
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010185505
VA PERMIER
VA
05
—
010185505
—
VA
01
—
10185505V
VCC
VA
01
—
186776
ANTHEM BC/BS
VA
01
—
329716
SOUTHERNHEALTH
VA
01
—
541588928
AETNA
VA
01
—
57114
CARENET
VA
01
—
9401772
PHCS
VA
01
—
98690
PTTIMAFAMILYCARE
VA
01
—
C03251
MCR GROUP
VA
Enumeration date
10/18/2006
Last updated
11/05/2012
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