Individual
PATRICIA ANNE DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
597 MERRIMACK ST, LOWELL COMMUNITY HEALTH CENTER, LOWELL, MA 01854
(978) 937-9700
(978) 446-9830
Mailing address
597 MERRIMACK ST, LOWELL COMMUNITY HEALTH CENTER, LOWELL, MA 01854
(978) 937-9700
(978) 446-9830
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
77409
MA
2080P0208X
Pediatric Infectious Diseases Physician
77409
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042881348
BEECH STREET
—
05
—
1305557
—
MA
01
—
1339
NEIGHBORHOOD HEALTH PLAN
—
01
—
204699
HARVARD PILGRIM HLTH CARE
—
01
—
22397
FALLON
—
01
—
3437455
AETNA
—
01
—
6469876
CIGNA
—
01
—
731688
TUFTS
—
01
—
9204204
UNITED HEALTH CARE
—
01
—
979892
NETWORK HEALTH
—
01
—
J14028
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/15/2006
Last updated
07/30/2008
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