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General NPI Number Information
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NPI Number | 1134271141
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Entity Type | Organization
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Legal Business Name | DICKSON WITMER ASSOCIATES
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1504 N BROOM ST SUITE 2
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City | WILMINGTON
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State | DE
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Zip | 19806-3087
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Country | US
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Telephone | 302-656-1882
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 N BROOM ST SUITE 2
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City | WILMINGTON
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State | DE
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Zip | 19806-3087
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Country | US
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Telephone | 302-656-1882
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DIANA DICKSON WITMER
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Credential | M.D.
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Telephone | 302-656-1882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C1-002159
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License Number State | DE
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