Organization
FAITH HACKETT, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH ALICE HACKETT M.D. (OWNER)
(410) 647-8300
Entity
Organization
Contact information
Practice address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21146-4127
(410) 647-8300
(410) 315-8444
Mailing address
844 RITCHIE HWY, SUITE 206, SEVERNA PARK, MD 21146-4127
(410) 647-8300
(410) 315-8444
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D32426
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
408221400
—
MD
Enumeration date
05/29/2008
Last updated
05/29/2008
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