MEDICARE: DR. WARREN T PICKARD II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	2008-00707	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	1265659288	OTHER	NC	AARP MEDICARE COMPLETE
6	2022597B	OTHER	NC	MEDICARE
10	1265659288	OTHER	NC	BLUE MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1265659288	OTHER	NC	NC BLUE CROSS
2	1265659288	OTHER	NC	HUMANA
4	1265659288	OTHER	NC	AETNA
5	1265659288	OTHER	NC	COMMERCIAL
7	1265659288	OTHER	NC	COVENTRY
8	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
9	1265659288	OTHER	NC	UNITED HEALTHCARE

General Provider Information

NPI Number	:	1265659288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN T PICKARD II MD

Provider Business Mailing Address
First Line	:	4901 E NC HIGHWAY 150
Second Line	:
City	:	BROWNS SUMMIT
State	:	NC
Zip	:	27214-9719
Country	:	US
Telephone Number	:	336-656-9905
Fax Number	:	336-656-5227

Provider Business Practice Location Address
First Line	:	4901 E NC HIGHWAY 150
Second Line	:
City	:	BROWNS SUMMIT
State	:	NC
Zip	:	27214-9719
Country	:	US
Telephone Number	:	336-656-9905
Fax Number	:	336-656-5227

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	10/01/2021

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