Individual
STEPHANIE HICKCOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 HOSPITAL RD, PRINCE FREDERICK, MD 20678-4017
(443) 949-0814
Mailing address
69 SCARLETT DR, HUNTINGTOWN, MD 20639-3705
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
C0006618
MD
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0006618
MARYLAND BOARD OF PHYSICIANS PA LICENSE
MD
Enumeration date
10/13/2017
Last updated
11/20/2022
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