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:
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Health care specialties

SpecialtyCodeLicense #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 13 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.

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Identifiers

StateTypeNumberIssuer
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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