Healthcare Provider Details

I. General information

NPI: 1437255726
Provider Name (Legal Business Name): STEVEN A PICKERT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S CENTER ST
THURMONT MD
21788-1910
US

IV. Provider business mailing address

100 S CENTER ST
THURMONT MD
21788-1910
US

V. Phone/Fax

Practice location:
  • Phone: 301-271-4333
  • Fax: 301-271-7486
Mailing address:
  • Phone: 301-271-4333
  • Fax: 301-271-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0015804
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: