Individual
DR. ANDREW C DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 BROADWAY, BANGOR, ME 04401
(207) 907-1155
(207) 907-1888
Mailing address
C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT, PO BOX 7291, LEWISTON, ME 04243-7291
(207) 777-8560
(207) 777-8800
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME13306
ME
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
013306
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013306
STATE MEDICAL LICENSE NUM
ME
05
—
163580000
—
ME
Enumeration date
03/25/2006
Last updated
03/10/2022
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