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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376514521 | NPPES |
| North Carolina | MEDICAID | 89129FP |
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