Individual
MARTA VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1434 PORTER ST, FORT DETRICK, MD 21702-9210
(301) 619-4820
Mailing address
1434 PORTER ST, FORT DETRICK, MD 21702-9254
(301) 619-4820
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R13197
NM
Other
Enumeration date
01/06/2006
Last updated
01/29/2009
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