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General NPI Number Information
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NPI Number | 1730248634
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Entity Type | Individual
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Provider Name | SARAH NICOLE VICK MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 06/04/2018
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Provider Practice Location Address
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Address Line | 1800 ORLEANS ST
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City | BALTIMORE
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State | MD
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Zip | 21287
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Country | US
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Telephone | 202-550-2963
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Fax |
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Provider Business Mailing Address
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Address Line | 430 JACOBSTOWN COOKSTOWN RD
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City | WRIGHTSTOWN
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State | NJ
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Zip | 08562-1608
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Country | US
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Telephone | 202-550-2963
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01061782A
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License Number State | IN
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