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Individual
DR. PAIGE G WICKNER
Active
Individual
DR. PAIGE G WICKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
244198
MA
208M00000X
Hospitalist Physician
044668
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044668
PHYSICIAN LICENSE NUMBER
CT
01
—
35877
CT CSR
CT
Enumeration date
12/13/2006
Last updated
03/07/2023
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