Healthcare Provider Details

I. General information

NPI: 1215623079
Provider Name (Legal Business Name): JULIA MAEVE HICKEY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 E CHESTNUT ST
AUGUSTA ME
04330-5758
US

IV. Provider business mailing address

6 E CHESTNUT ST
AUGUSTA ME
04330-5758
US

V. Phone/Fax

Practice location:
  • Phone: 207-623-6560
  • Fax: 207-623-6571
Mailing address:
  • Phone: 207-623-6560
  • Fax: 207-623-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO4292
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: