Individual
TAMARA D DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8535 N CLEARVIEW DR STE 700, MCCORDSVILLE, IN 46055-6243
(317) 415-6450
Mailing address
8535 N CLEARVIEW DR STE 700, MCCORDSVILLE, IN 46055-6243
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01049288
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200192260
—
IN
Enumeration date
06/15/2006
Last updated
06/17/2022
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