Provider Demographics
NPI:1104890615
Name:DIXON-CHERRY, TWANNA BELINDA (MD)
Entity type:Individual
Prefix:MRS
First Name:TWANNA
Middle Name:BELINDA
Last Name:DIXON-CHERRY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1886
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27889-1886
Mailing Address - Country:US
Mailing Address - Phone:252-940-0602
Mailing Address - Fax:252-940-0605
Practice Address - Street 1:118 W MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:NC
Practice Address - Zip Code:27889-4906
Practice Address - Country:US
Practice Address - Phone:252-940-0602
Practice Address - Fax:252-940-0605
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical Genetics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCH91410Medicare UPIN