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Individual

DR. EDWARD ERNEST DICKERSON, IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2053 VALLEYGATE DR STE 102, FAYETTEVILLE, NC 28304-3983
(910) 323-9222
Mailing address
PO BOX 2814, BRYSON CITY, NC 28713-2814
(910) 239-7600
(828) 538-4441

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
9400044
NC
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
9400044
NC
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
94-00044
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89129FP
NC
Enumeration date
01/27/2006
Last updated
10/12/2023
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