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Individual

PATRICIA A DICKERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1299 E ALEX BELL RD, CENTERVILLE, OH 45459-2658
(937) 436-1117
(937) 436-9576
Mailing address
1299 E ALEX BELL RD, CENTERVILLE, OH 45459-2658
(937) 436-1117
(937) 436-9576

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
350554000
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0866648
OH
Enumeration date
08/30/2005
Last updated
11/05/2012
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