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Individual

DR. RICHARD S DICKMEYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1270 E STATE ROAD 205, SUITE 240, COLUMBIA CITY, IN 46725-9499
(260) 244-7600
(260) 244-5212
Mailing address
1234 E DUPONT RD, SUITE 3, FORT WAYNE, IN 46825-1545
(260) 373-9700
(260) 373-9740

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01029443
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000325785
ANTHEM
IN
01
000000570550
ANTHEM
IN
05
100263110A
IN
01
1229
PHP
IN
01
1977073
CIGNA
IN
01
351972384039
TRICARE
IN
01
3937240025
MEDICARE DMEPOS
IN
01
4048678
AETNA
IN
01
P00467073
RAILROAD MEDICAE
IN
Enumeration date
08/02/2005
Last updated
09/24/2012
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