Max Robert Dickerson, ATC

Athletic Trainer · Wayne, MI

Individual Active NPI

NPI number 1205339728

Practice location

3999 Venoy Rd
Wayne, MI 48184-1485
Phone
(734) 727-0440

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NPI record

NPI
1205339728
Entity type
Individual (Type 1)
Enumeration date
March 11, 2018
Last updated
March 11, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X L946620 MI

Mailing address

15905 Foch St
Livonia, MI 48154-3485
Phone
(248) 872-9226

About Max Dickerson

Max Robert Dickerson, ATC is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 3999 Venoy Rd, Wayne, MI 48184-1485. The NPI number 1205339728 was assigned on March 11, 2018 and the record was last updated on March 11, 2018.

Max Dickerson lists a license in the registry: #L946620 (MI) for Athletic Trainer. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Max Robert Dickerson, ATC?

The NPI number is 1205339728.

What is the phone number of Max Dickerson?

The phone number listed for the practice location is (734) 727-0440.

Where is Max Dickerson located?

3999 Venoy Rd, Wayne, MI 48184-1485.

What is the taxonomy code for Max Dickerson?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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