Dickson, Terry Marc
Dickson, Terry Marc is an individual health care provider with primary practice located at 745 S Garfield Ave Suite C, Traverse City MI 49686-3479. He recently has only one registered license in Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics, which is considered as his primary health care specialty. Dickson, Terry Marc can be contacted via phone (231) 932-1250.Contact Information
Primary practice address
745 S Garfield Ave Suite C
Traverse City MI 49686-3479
Phone: (231) 932-1250
Fax: (231) 932-1266
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Developmental – Behavioral Pediatrics | 2080P0006X | 4301062201 | Michigan |
Profile Details
NPI number | 1851505978 |
---|---|
LBN Legal business name | Dickson, Terry Marc |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 9th, 2007 |
Last updated | Aug 27th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1851505978 | NPPES |
Michigan | Other | 0280327 | BLUE CROSS BLUE SHIELD MI |
Michigan | MEDICAID | 104467082 | BLUE CROSS BLUE SHIELD MI |
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