Individual
DR. THEODORE ARTHUR DIZIKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-2676
Mailing address
PO BOX 670884, DETROIT, MI 48267-0884
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
5101029541
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2019
Last updated
08/03/2026
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