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General NPI Number Information
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NPI Number | 1528103678
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Entity Type | Individual
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Provider Name | ELIZABETH ANDERSON DICKINSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 964 LOCHEND DR
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City | DARLINGTON
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State | SC
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Zip | 29532-5698
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Country | US
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Telephone | 843-777-6890
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Fax | 843-777-6891
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Provider Business Mailing Address
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Address Line | PO BOX 3239
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City | FLORENCE
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State | SC
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Zip | 29502-3239
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Country | US
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Telephone | 843-777-6870
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Fax | 843-777-6871
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 12821
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12821
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License Number State | SC
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