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General NPI Number Information
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NPI Number | 1831388552
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Entity Type | Organization
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Legal Business Name | BENJAMIN C DICKERT
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 222 CAREW ST STE 101
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City | SPRINGFIELD
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State | MA
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Zip | 01104-4105
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Country | US
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Telephone | 413-736-3225
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Fax | 413-736-3382
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Provider Business Mailing Address
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Address Line | 222 CAREW ST STE 101
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City | SPRINGFIELD
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State | MA
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Zip | 01104-4105
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Country | US
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Telephone | 413-736-3225
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Fax | 413-736-3382
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN C. DICKERT
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Credential | D.P.M.
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Telephone | 413-736-3225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | PD1884
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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