Dickerson, Iv, Edward Ernest

Dickerson, Iv, Edward Ernest is an individual health care provider with primary practice located at 2053 Valleygate Dr Ste 102 , Fayetteville NC 28304-3983. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery, Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is his primary health care specialty. Dickerson, Iv, Edward Ernest can be contacted via phone (910) 323-9222.

Contact Information

Primary practice address
2053 Valleygate Dr Ste 102 Fayetteville NC 28304-3983
Phone: (910) 323-9222
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology/Facial Plastic Surgery 207YX0905X 9400044 North Carolina
Allopathic & Osteopathic Physicians / Plastic Surgery Within the Head and Neck 2082S0099X 94-00044 North Carolina
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 9400044 North Carolina

Profile Details

NPI number 1376514521
LBN Legal business name Dickerson, Iv, Edward Ernest
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2006
Last updated Oct 12th, 2023 - about 3 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 1376514521 NPPES
North Carolina MEDICAID 89129FP

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