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NPI Code Detail

MEDICARE: DR. CICELY MONIQUE PICKETT MD

MEDICARE: DR. CICELY MONIQUE PICKETT 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
1207V00000XObstetrics & Gynecology PhysicianD61821MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20038OTHERMDCAREFIRST-DC
3642258-02OTHERMDCAREFIRST-MD

General Provider Information

NPI Number : 1932105145
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CICELY MONIQUE PICKETT MD
Provider Business Mailing Address
First Line : 701 PUMPHREY FARM DR
Second Line :
City : MILLERSVILLE
State : MD
Zip : 21108-1485
Country : US
Telephone Number : 410-299-5101
Fax Number :
Provider Business Practice Location Address
First Line : 1701 TWIN SPRINGS RD
Second Line :
City : HALETHORPE
State : MD
Zip : 21227-3553
Country : US
Telephone Number : 800-777-7904
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/17/2021

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