Individual
DR. RENEE B HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
23203 COLUMBUS RD STE I, COLUMBUS, NJ 08022-1985
(609) 303-4450
(609) 303-4451
Mailing address
1 THIRD ST, BORDENTOWN, NJ 08505-1321
(609) 298-2005
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10235700
NJ
207Q00000X
Family Medicine Physician
MD072498L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018417270004
—
PA
01
—
1301488
HIGHMARK
PA
Enumeration date
06/07/2006
Last updated
04/29/2021
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