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NPI Code Detail

MEDICARE: DR. MICHAEL SCOTT DICK M.D.

MEDICARE: DR. MICHAEL SCOTT DICK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianA96147CA

General Provider Information

NPI Number : 1558406538
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL SCOTT DICK M.D.
Provider Business Mailing Address
First Line : 2141 26TH ST UNIT 301
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-4414
Country : US
Telephone Number : 202-669-4030
Fax Number :
Provider Business Practice Location Address
First Line : 2141 26TH ST UNIT 301
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94107-4414
Country : US
Telephone Number : 202-669-4030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 12/13/2010

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