Provider Demographics
NPI:1609912039
Name:DICKERT, NEAL WORKMAN JR (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:WORKMAN
Last Name:DICKERT
Suffix:JR
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:EMORY UNIVERSITY SCHOOL OF
Mailing Address - Street 2:101 WOODRUFF CIRCLE, WMB 319
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-759-9131
Mailing Address - Fax:
Practice Address - Street 1:EMORY UNIVERSITY SCHOOL OF
Practice Address - Street 2:101 WOODRUFF CIRCLE, WMB 319
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-759-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63184207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease