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Contact Information

EDWARD E DICKERSON IV, MD
2053 VALLEYGATE DR STE 102
FAYETTEVILLE, NC28304-3983
 Phone: 910-323-9222
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Otolaryngology/Facial Plastic Surgery

207YX0905X 04 Physician/Otolaryngology
 

Plastic Surgery Within the Head and Neck

2082S0099X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for EDWARD E DICKERSON IV · (Male)

NPI # 1376514521
Status Active
Credentials MD
Entity Individual
Enumeration date 01/27/2006
Last updated 10/12/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 94-00044
  • NC License # 9400044
  • NC Medicaid 89129FP
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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