Individual
DR. DAVID STANFORD DICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4212 N 16TH ST, PHOENIX, AZ 85016-5319
(602) 263-1511
(602) 263-1619
Mailing address
PO BOX 31000-0698, PASADENA, CA 91110-0698
(602) 263-1511
(602) 263-1619
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
10888
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0721790
BCBS
AZ
Enumeration date
10/12/2006
Last updated
07/09/2007
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