Mary Beth Dixon, PA

Individual provider Active NPI Physician Assistant · Browns Summit, NC

NPI 1245338359 · NPPES record last updated Jan 11, 2013

Key facts

NPI
1245338359
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
102841 (NC)
Practice address
4901 E NC Highway 150
Browns Summit, NC 27214-9719
Phone
(336) 656-9905
Fax
(336) 656-5227
NPI assigned
Sep 20, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102841NCMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102841 NC Yes

Addresses

Primary practice location

4901 E NC Highway 150
Browns Summit, NC 27214-9719

Mailing address

4901 E NC Highway 150
Browns Summit, NC 27214-9719
Phone (336) 656-9905

Other identifiers

IdentifierTypeStateIssuer
1245338359OtherNCNC BLUE CROSS
2759132BOtherNCMEDICARE

Other providers in Browns Summit, NC

All providers in Browns Summit, NC · Physician Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.