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Individual

FAITH ALICE HACKETT

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21146
(410) 647-8300
(410) 315-8444
Mailing address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21146
(410) 647-8300
(410) 315-8444

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
D32426
MD
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D32426
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03794
AMERICAID
01
0553696119
UHC HMO
01
06704
PHN
01
0H64
CBCBS
MD
01
11120
BS POS
01
38000
JHEHP
MD
01
38000
EHP
01
4077FA
MC
01
4338237
AETNA
01
726556
US AETNA (HMO)
01
811265
MD/OP/ALLIANCE
01
OH64
BS
01
T5930001
BSFED
01
T593001
BLUE CHOICE
Enumeration date
02/03/2006
Last updated
09/11/2025
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