DR. ETOSHA D DIXON (NPI# 1063473551) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1063473551 |
Entity Type | Individual |
Full Name | DR. ETOSHA D DIXON |
Credential | M.D. |
Practice Address |
4538 Edmondson Ave Baltimore MD 21229-1506 |
Mailing Address |
5525 Research Park Dr Fl 4 Baltimore MD 21228-4873 |
Practice Telephone | 4103282273 |
Practice Fax Number | 4103621750 |
Mailing Telephone | 4108823240 |
Mailing Fax Number | 4106615093 |
Enumeration Date | 2006-04-01 |
Last Update Date | 2020-06-29 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207Q00000X | Family Medicine | 22045 | WV | Allopathic & Osteopathic Physicians |
Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
D61785 | MD | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BCBS MD | 89660801 | 01 | |
CAREFIRST BCBS OF DC | 9676-0039 | 01 | |
CAREFIRST BCBS OF MD | 093NSE-896608-01 | 01 | |
BCBS | 769698 | 01 | |
EVERCARE | 0442052 | 01 | |
CAREFIRST BCBS OF MD | 093NER-896608-01 | 01 | |
BCBS-DC | T016-0057 | 01 | |
MD | 005559001 | 05 | |
CAREFIRST DC | 0056 | 01 | |
EVERCARE | 0123302 | 01 | |
MD | 805701000 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
8800 Walther Blvd, Baltimore, MD 212349001 | 4108823240 | 4106615093 |
Street Address |
4538 EDMONDSON AVE |
City | BALTIMORE |
State | MD |
Zip Code | 21229-1506 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851907141 | Time Organization, Inc. | Community/Behavioral Health | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2020-09-22 |
1629210166 | University Care | Psychologist | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2009-03-30 |
1063512200 | Catharine Louise Weiss | Psychologist | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-09-25 |
1497760276 | University Care LLC | Internal Medicine | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-07-30 |
1134153034 | Neil Siegel | Emergency Medicine | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-07-10 |
1275565251 | Marc Wilson | Emergency Medicine | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-07-07 |
1164454005 | Joyce Evans | Family Medicine | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-07-07 |
1245269018 | Stacy Garrett | Emergency Medicine | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-07-02 |
1306885280 | Ivara Alistair Esege | Specialist | 4538 Edmondson Ave, Baltimore, MD 21229-1506 | 2006-06-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265068373 | Bodyworks Medical | Clinic/Center | St. Agnes Medical Center, 3455 Wilkens Ave Suite 100, Baltimore, MD 21229 | 2020-03-20 |
1750932430 | Amanda Felix | Nurse Practitioner | 5411 Old Frederick Road, Catonsville, MD 21229 | 2019-09-24 |
1497317853 | Wakeelat A Adeoye | Nurse Practitioner | 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 | 2019-07-05 |
1598328080 | Oprah Cherelle Keyes | Social Worker | 4511 Birchwood Drive, Baltimore, MD 21229 | 2019-04-19 |
1477051779 | Shahin Vohara | Dentist | Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 | 2018-02-01 |
1386179299 | Sharon Mccollough | Counselor | 3219 Phelps Lane, First Floor, Baltimore, MD 21229 | 2017-04-28 |
1184175697 | Yekeen Odewale | Registered Nurse | 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 | 2016-10-19 |
1942608070 | Charity Ashe | Social Worker | 4024 Colborne Rd, Baltimore, MD 21229 | 2014-12-05 |
1376947127 | Sumanya Venkat Rao | Dentist | 4510 Edmondson Ave, Baltimore, MD 21229 | 2014-10-21 |
1497091573 | Anita Phillips | Social Worker | 5110 Frederick Avenue, Baltimore, MD 21229 | 2012-12-18 |
Find all providers in zip 21229 |
Taxonomy Code | 207QG0300X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Geriatric Medicine |
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336140524 | George Hennawi | Family Medicine | 5601 Loch Raven, Russell Morgan, Baltimore, MD 21239 | 2005-08-10 |
1902158678 | Bravo Health Advanced Care Center, P.C. | Family Medicine | 312 Martin Luther King Jr Blvd, Baltimore, MD 21201-1221 | 2012-10-05 |
1336217819 | James Paul Richardson | Family Medicine | 900 Caton Ave, Department of Medicine, Sixth Floor, Baltimore, MD 21229-5201 | 2006-12-01 |
1235217225 | Shari Miura Ling | Family Medicine | 3001 S Hanover St, Room Nm533, Baltimore, MD 21225-1233 | 2006-11-01 |
1912921453 | Karen A. Cousins | Family Medicine | 827 Linden Ave, Baltimore, MD 21201 | 2006-07-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376735100 | Edger V Potter Jr Md Inc | Family Medicine | 12017 Fort Washington Rd, Fort Washington, MD 20744-6004 | 2007-08-15 |
1750595401 | Ted Eric Howe | Family Medicine | 18100 Slade School Rd, Sandy Spring, MD 20860-1313 | 2007-05-10 |
1265594493 | Andres Salazar | Family Medicine | 3621 Ligon Rd, Ellicott City, MD 21042-5238 | 2006-12-14 |
1497841563 | Farzana Ajmal | Family Medicine | 19731 Executive Park Cir, Germantown, MD 20874-2642 | 2006-10-05 |
1942391693 | Paul A. Devore Md PC | Family Medicine | 4203 Queensbury Rd, Hyattsville, MD 20781-1435 | 2006-09-27 |
1063445013 | Lifestyle Medical Center, Cheryl Brown-christopher M. D., Chartered | Family Medicine | 116 Defense Hwy Ste 200, Annapolis, MD 21401-7045 | 2006-07-09 |
1932135548 | Nagji J Sureja | Family Medicine | 4212 Ridge Rd, Westminster, MD 21157-7849 | 2006-06-24 |
1689612236 | Raman Tuli, Md, P.C. | Family Medicine | 10810 Darnestown Rd, Suite 202, Gaithersburg, MD 20878-2675 | 2006-06-04 |
1851346423 | Arvind D Desai | Family Medicine | 30 Corporate Center, 10440 Little Patuxent Parkway, Suite 300, Columbia, MD 21044-3648 | 2006-05-23 |
1134102775 | Cyrus Hamidi | Family Medicine | 913 Ridgebrook Rd, Suite 312, Sparks, MD 21152-9451 | 2005-11-29 |
Find all providers with the same taxonomy |
Please comment or provide details below to improve the information on DR. ETOSHA D DIXON.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.