Individual
DR. JOHN QUENITH DICKEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5210 HIGHLAND RD STE 200, WATERFORD, MI 48327-1970
(248) 625-9099
(248) 625-4632
Mailing address
5210 HIGHLAND RD STE 200, WATERFORD, MI 48327-1970
(248) 625-9099
(248) 625-4632
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
JD009226
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F31072
BCBSM COMMON PROVIDER ID
MI
01
—
101601
CARE CHOICES
MI
01
—
310F337240
BCBSM CMG
MI
01
—
5630343
BCBSM
MI
01
—
C4251
M-CARE
MI
01
—
F00492
HEALTH ALLIANCE PLAN
MI
Enumeration date
08/30/2005
Last updated
03/05/2020
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