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General NPI Number Information
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NPI Number | 1407867385
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Entity Type | Individual
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Provider Name | CHAD R. DICKEMORE DPM
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 330 N 10TH ST STE B
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City | HAMILTON
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State | MT
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Zip | 59840-2318
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Country | US
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Telephone | 406-363-4214
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Fax | 406-363-4354
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Provider Business Mailing Address
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Address Line | 330 N 10TH ST STE B
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City | HAMILTON
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State | MT
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Zip | 59840-2318
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Country | US
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Telephone | 406-363-4214
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Fax | 406-363-4354
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 169
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License Number State | MT
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