Healthcare Provider Details

I. General information

NPI: 1568873156
Provider Name (Legal Business Name): MARGARET ELIZABETH WHICKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 CHERRY ST SE
GRAND RAPIDS MI
49503-4608
US

IV. Provider business mailing address

3400 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-5127
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-5600
  • Fax: 616-685-6745
Mailing address:
  • Phone: 267-624-4446
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMD467063
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: