Provider Demographics
NPI:1326046327
Name:DIX, GARY ALFRED (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALFRED
Last Name:DIX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BESTGATE RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-3371
Mailing Address - Country:US
Mailing Address - Phone:410-266-2720
Mailing Address - Fax:410-224-0209
Practice Address - Street 1:1000 BESTGATE RD STE 400
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3371
Practice Address - Country:US
Practice Address - Phone:410-266-2720
Practice Address - Fax:410-224-0209
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055232207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
60967804OtherBCBS
60967806OtherBCBS
DCW8490003OtherBCBS
3641780OtherAETNA HMO
MD60967807OtherBCBS
MD60967808OtherBCBS
804001000OtherAMERIGROUP
394843OtherMAMSI
487760200OtherFEDERAL WORKMANS COMP
DCD3800003OtherBCBS
7580269OtherAETNA
60967803OtherBCBS
MD804001000Medicaid
DCJ4570005OtherBCBS
DCW8490003OtherBCBS
DCJ4570005OtherBCBS
MD60967807OtherBCBS
MD804001000Medicaid