Most Relevant Information
Provider Data
| NPI Number: | 1003042268 |
| Provider Name: | IAN EDWIN DICK PA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/02/2009 |
| Last Updated: | 03/30/2011 |
Provider Practice Location
900 E SIX FORKS RD
#532
RALEIGH
NC
276041818
Practice Location Phone/Fax
| Phone: | 6147834186 |
| Fax: |
Provider Mailing Location
900 E SIX FORKS RD
#532
RALEIGH
NC
276041818
Provider Mailing Phone/Fax
| Phone: | 6147834186 |
| Fax: |