Provider Demographics
NPI:1346212602
Name:DIMICK, ROBERT MARSHALL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARSHALL
Last Name:DIMICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1321 MURFREESBORO ROAD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37217
Mailing Address - Country:US
Mailing Address - Phone:615-366-8890
Mailing Address - Fax:615-366-3379
Practice Address - Street 1:5651 FRIST BOULEVARD
Practice Address - Street 2:SUITE 500
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076
Practice Address - Country:US
Practice Address - Phone:615-889-3340
Practice Address - Fax:615-889-6087
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN25983207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4079243OtherBCBS
TN3143916OtherBCBS
TN3085662Medicaid
TN3143916OtherBCBS
TN0922510006Medicare PIN
TNP00164066Medicare PIN
TN3085662Medicaid