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NPI Code Detail

MEDICARE: DR. MAUREEN COLETTE HICKERT MD

MEDICARE: DR. MAUREEN COLETTE HICKERT 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
12084P0800XPsychiatry Physician35065302HOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558476457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAUREEN COLETTE HICKERT MD
Provider Business Mailing Address
First Line : 3628 VICTORIA LANE
Second Line :
City : CINCINNATI
State : OH
Zip : 45208
Country : US
Telephone Number : 513-207-7311
Fax Number : 513-559-3848
Provider Business Practice Location Address
First Line : 2621 VICTORY PKWY
Second Line :
City : CINCINNATI
State : OH
Zip : 45206-1754
Country : US
Telephone Number : 513-861-6688
Fax Number : 513-559-3848
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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