Basic Information
Provider Information
NPI: 1205881794
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DIXON
FirstName: ANNE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 230 WORCESTER ST
Address2:  
City: WELLESLEY
State: MA
PostalCode: 024815420
CountryCode: US
TelephoneNumber: 7814315429
FaxNumber: 7814315548
Practice Location
Address1: 230 WORCESTER ST
Address2:  
City: WELLESLEY
State: MA
PostalCode: 024815420
CountryCode: US
TelephoneNumber: 7814315429
FaxNumber: 7814315548
Other Information
ProviderEnumerationDate: 05/23/2006
LastUpdateDate: 12/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X227077MAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
622651101MACIGNAOTHER
AA5532601MAHARVARD PILGRIMOTHER
J2979401MABLUE CROSSOTHER
49458101MATUFTS HEALTH PLANOTHER
003746301MANEIGHBORHOOD HEALTH PLANOTHER


Home