Individual
CHRIS J DICKINSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 EAST MEDICAL CENTER DR, 8TH FLOOR CS MOTT CHILDRENS HOSPITAL, ANN ARBOR, MI 48109-4259
(734) 936-4185
Mailing address
3621 S STATE ST, 700 KMS PLACE ATTN ELLEN KAYFES, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301048129
MI
2080P0206X
Pediatric Gastroenterology Physician
4301048129
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1728630
—
MI
05
—
4249691
—
MI
Enumeration date
07/27/2006
Last updated
10/14/2013
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