Organization
LIBERTY PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS D. HICKEY M.D. (OWNER)
(410) 549-0900
Entity
Organization
Contact information
Practice address
1030 LIBERTY RD, SUITE 100, ELDERSBURG, MD 21784-7941
(410) 549-0900
(410) 549-6121
Mailing address
1030 LIBERTY RD, SUITE 100, ELDERSBURG, MD 21784-7941
(410) 549-0900
(410) 549-6121
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
R213300
MD
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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