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IVY WICKS MD NPI 1093247769


NPI Information

NPI: 1093247769
Provider Name: IVY WICKS, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
12070 OLD LINE CTR STE 302
WALDORF, MD
ZIP 20602
Phone: (301) 645-6667
Get Directions

Ivy Wicks, MD is a family medicine in Waldorf, MD with 7 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Ivy Wicks, MD NPI is 1093247769. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: MEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduation Year:2017

The provider's business location address is:

12070 OLD LINE CTR STE 302
WALDORF, MD
ZIP 20602-567
Phone: (301) 645-6667
Fax: (301) 870-9722

The NPI 1093247769 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2017 and was last updated on 7/31/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineD0091620MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.