Individual
DR. ANDREA G. DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
210 MAIN STREET, MANCHESTER, CT 06040
(860) 646-0313
(860) 643-3086
Mailing address
210 MAIN STREET, MANCHESTER, CT 06040
(860) 646-0313
(860) 643-3086
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
045265
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6224
LAST 4 OF EIN
CT
Enumeration date
05/10/2006
Last updated
09/29/2016
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