Wickman, Douglas W

Wickman, Douglas W is an individual health care provider with primary practice located at 71 Prospect Ave , Hudson NY 12534-2907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wickman, Douglas W can be contacted via phone (518) 697-3208.

Contact Information

Primary practice address
71 Prospect Ave Hudson NY 12534-2907
Phone: (518) 697-3208
Fax: (518) 697-3207
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD23937 Oregon
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 248055 New York

Profile Details

NPI number 1447228325
LBN Legal business name Wickman, Douglas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated May 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447228325 NPPES
Oregon MEDICAID 286348

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