Healthcare Provider Details

I. General information

NPI: 1124433982
Provider Name (Legal Business Name): MEREDITH WARD DICKSON DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH LEIGH WARD DPM

II. Dates (important events)

Enumeration Date: 06/30/2014
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 MULBERRY ST SW STE 102
LENOIR NC
28645-5463
US

IV. Provider business mailing address

1180 BEAR CREEK RD
LEICESTER NC
28748-6313
US

V. Phone/Fax

Practice location:
  • Phone: 828-757-6434
  • Fax:
Mailing address:
  • Phone: 910-603-5487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number659
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number659
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: