Dixon, Etosha D

Dixon, Etosha D is an individual health care provider with primary practice located at 8800 Walther Blvd , Baltimore MD 21234-9001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Geriatric Medicine. Allopathic & Osteopathic Physicians / Geriatric Medicine is her primary health care specialty. Dixon, Etosha D can be contacted via phone (410) 882-3240.

Contact Information

Primary practice address
8800 Walther Blvd Baltimore MD 21234-9001
Phone: (410) 882-3240
Fax: (410) 661-5093
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22045 West Virginia
Allopathic & Osteopathic Physicians / Geriatric Medicine 207QG0300X D61785 Maryland

Profile Details

NPI number 1063473551
LBN Legal business name Dixon, Etosha D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 1st, 2006
Last updated Apr 21st, 2022 - about 2 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 1063473551 NPPES
Other 0123302 EVERCARE
Other 9676-0039 EVERCARE
MEDICAID 005559001 EVERCARE
Other 0056 EVERCARE
Other T016-0057 EVERCARE
Other 0442052 EVERCARE
Other 769698 EVERCARE
Other 093NSE-896608-01 EVERCARE
MEDICAID 805701000 EVERCARE
Other 093NER-896608-01 EVERCARE
Other 89660801 EVERCARE

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