Provider Demographics
NPI:1689453912
Name:DIXON, NEMA D (MD)
Entity Type:Individual
Prefix:
First Name:NEMA
Middle Name:D
Last Name:DIXON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17517 CHRISTER ST
Mailing Address - Street 2:
Mailing Address - City:POOLESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20837-2063
Mailing Address - Country:US
Mailing Address - Phone:202-255-5583
Mailing Address - Fax:
Practice Address - Street 1:17517 CHRISTER ST
Practice Address - Street 2:
Practice Address - City:POOLESVILLE
Practice Address - State:MD
Practice Address - Zip Code:20837-2063
Practice Address - Country:US
Practice Address - Phone:202-255-5583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNON-MEDICAL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide