Individual
MARTHA A HICKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3025 GOVERNORS PLACE BLVD, DAYTON, OH 45409
(937) 293-5567
(937) 293-5568
Mailing address
3025 GOVERNORS PLACE BLVD, DAYTON, OH 45409
(937) 293-5567
(937) 293-5568
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
35-06-0161
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2088646
—
OH
Enumeration date
10/10/2005
Last updated
04/19/2011
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