Individual
DR. HENRY S WICKER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4701 SPOTSYLVANIA PKWY, SUITE 203, FREDERICKSBURG, VA 22407-9435
(540) 834-5450
(540) 834-5451
Mailing address
PO BOX 1460, FREDERICKSBURG, VA 22402-1460
(540) 786-2100
(540) 786-0677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101044445
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007306172
—
VA
01
—
0101044445
LICENSE
VA
01
—
0898260
AETNA HMO
VA
01
—
137724
ANTHEM
VA
01
—
4235093
AETNA NON HMO
VA
01
—
425273
MAMSI
VA
01
—
C02375
MEDICARE GROUP
VA
01
—
CA9037
MCR RAILROAD GROUP
VA
Enumeration date
02/08/2006
Last updated
02/10/2022
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