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Individual

JONATHAN A DYER

Active
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Individual

JONATHAN A DYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
2001014980
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
189164
BLUE SHIELD/BLUE CHOICE
MO
05
209312404
MO
01
300639
UNITED HEALTHCARE
MO
01
658400
HEALTHLINK
MO
Enumeration date
05/04/2006
Last updated
09/14/2022
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