Individual
BRUCE EDWARD HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 E SUMNER ST, HARTFORD, WI 53027
(262) 670-4000
(262) 670-4451
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
39580
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01115320
RR MEDICARE
WI
Enumeration date
08/23/2006
Last updated
01/23/2013
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