MR. EVAN NATHAN DICKSTEIN


Address: 5301 Buckeystown Pike, Frederick, MD 21704-8370
Phone: 3017330330

MR. EVAN NATHAN DICKSTEIN (NPI# 1942688379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942688379
Entity Type Individual
Full Name MR. EVAN NATHAN DICKSTEIN
Credential NP-PMH
Practice Address 5301 Buckeystown Pike
Frederick
MD 21704-8370
Mailing Address 13121 Brook Lane
Hagerstown
MD 21742-1945
Practice Telephone 3017330330
Practice Fax Number 3017334038
Mailing Telephone 3017330330
Mailing Fax Number 3017334038
Enumeration Date 2015-05-18
Last Update Date 2018-02-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 163W00000X Registered Nurse R200789 MD Nursing Service Providers
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
R200789 MD Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 5301 BUCKEYSTOWN PIKE
City FREDERICK
State MD
Zip Code 21704-8370

Providers in the same location

NPI Name Taxonomy Address Enumeration
1972584233 Andrew B. Johnson Psychiatry & Neurology 5301 Buckeystown Pike, Frederick, MD 21704-8370 2005-11-14
1366093098 Shannon Snowman Student in an Organized Health Care Education/Training Program 5301 Buckeystown Pike, Stet 170, Frederick, MD 21704 2019-09-24
1538657630 Brook Lane Behavioral Services, Inc. Clinic/Center 5301 Buckeystown Pike, Frederick, MD 21704-8370 2018-04-25
1649624198 Mary Noble Counselor 5301 Buckeystown Pike, Frederick, MD 21704-8370 2016-04-21
1558715185 Melissa Crigger Counselor 5301 Buckeystown Pike, Frederick, MD 21704-8370 2016-04-20
1174986558 Marta Menendez-voss Social Worker 5301 Buckeystown Pike, Frederick, MD 21704-8370 2016-04-01
1962890962 Emily Collingham Counselor 5301 Buckeystown Pike, Frederick, MD 21704-8370 2014-12-30
1518361690 Maria Murphy Counselor 5301 Buckeystown Pike, Frederick, MD 21704-8370 2014-10-17
1932511714 James Arthur Schiller Social Worker 5301 Buckeystown Pike, Frederick, MD 21704-8370 2014-05-28
1952729568 Samantha Elizabeth Wilt Social Worker 5301 Buckeystown Pike, Frederick, MD 21704-8370 2014-04-01
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144747148 Danah Jack Physical Therapist 4070 Atterbury Place, Frederick, MD 21704 2017-08-29
1568986891 Amy Benjamin Slp Speech-Language Pathologist 8905 Amelung St, Frederick, MD 21704 2017-07-28
1104352368 Mentor-maryland Community/Behavioral Health 5970 Frederick Crossing Lane, #202, Frederick, MD 21704 2017-05-10
1699193284 Jiang Tan Acupuncturist 3520 Worthington Blvd #101, Frederick, MD 21704 2014-04-01
1326460817 Jessica Lacayo Nurse Practitioner 3350 Worthington Boulevard, Urbana, MD 21704 2014-01-17
1588098818 Kimberly Kaye Dipietro Registered Nurse 9006 Harris Street, Frederick, MD 21704 2013-08-22
1831432525 Yuqing Meng Pharmacist 9317 Elgin Lane, Frederick, MD 21704 2013-04-01
1831446285 Diane Marie Foland Behavioral Analyst 4235 Lafayette Street, Frederick, MD 21704 2012-08-03
1982932695 Contemporary Therapeutic Services Inc Community/Behavioral Health 22 N Potomac Street, Ste 102, Hagerstown, MD 21704 2009-11-19
1942461181 Hoa T K Lam Dentist 7360 Guilford Drive, Suite #102, Frederick, MD 21704 2008-06-20
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1821560525 Titus Koimur Nurse Practitioner 107 Bierstadt Ct, Frederick, MD 21702-6442 2018-12-19
1508338203 Joel Griffith Nurse Practitioner 251 W Patrick St, Frederick, MD 21701-6942 2018-12-19
1831610161 William Haynes Nurse Practitioner 103 Water Land Ct., Frederick, MD 21702 2017-06-27
1235672205 Julie Ann Dagenhart Nurse Practitioner 1003 W 7th St Ste 403, Frederick, MD 21701-8532 2016-11-23
1689286197 Kelly Amike Ngenge Nurse Practitioner 107 Bierstadt Ct, Frederick, MD 21702-6442 2020-08-18
1477197424 Jaclyn Blaire Daugherty Nurse Practitioner 604 Solarex Ct Unit 201, Frederick, MD 21703-8655 2019-11-03
1386298768 Molly Kathryn Aitken Nurse Practitioner 1003 W 7th St Ste 403, Frederick, MD 21701-8532 2019-07-24
1457844722 Phoebe Antoinette Underwood-davis Nurse Practitioner 5301 Buckeystown Pike Ste 170, Frederick, MD 21704 2018-06-12
1730677121 Michelle Lynn Ridgeway Nurse Practitioner 400 W 7th St, Frederick, MD 21701 2018-05-01
1295270445 Carolyn Calleo Nurse Practitioner 604 Solarex Ct, Suite 201, Frederick, MD 21703-7005 2016-12-27
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Competitor

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City FREDERICK
Zip Code 21704

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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