Individual
MR. DAVID HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
2331 PROGRESS ST, SUITE D, WEST BRANCH, MI 48661-9384
(989) 345-1184
(989) 345-6944
Mailing address
2331 PROGRESS ST, SUITE D, WEST BRANCH, MI 48661-9384
(989) 345-1184
(989) 345-6944
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704082187
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4747184
—
MI
05
—
4747193
—
MI
01
—
5008768480
BCBS PIN
MI
01
—
700G210140
BCBS GROUP
MI
Enumeration date
07/06/2006
Last updated
01/27/2009
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