Individual
PETER WICKWIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2521 STOCKTON BLVD, STE 7200, SACRAMENTO, CA 95817-2207
(916) 734-5005
Mailing address
2521 STOCKTON BLVD, STE 7200, SACRAMENTO, CA 95817-2207
(916) 734-5005
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
T1604
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
03/24/2016
Last updated
09/29/2021
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