MEDICARE: DR. MAROUN T 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
1	2084N0400X	Neurology Physician	MD 019531	TN
2	2084N0600X	Clinical Neurophysiology Physician	MD 019531	TN
3	2084N0400X	Neurology Physician	19531	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942273826
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAROUN T DICK M.D.

Provider Business Mailing Address
First Line	:	8577 CORDES CIR
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-3317
Country	:	US
Telephone Number	:	901-590-0886
Fax Number	:	901-590-0071

Provider Business Practice Location Address
First Line	:	8577 CORDES CIR
Second Line	:
City	:	GERMANTOWN
State	:	TN
Zip	:	38139-3317
Country	:	US
Telephone Number	:	901-590-0886
Fax Number	:	901-590-0071

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	01/13/2017

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