Individual
DR. JOHN ROBERT TICEHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7385 BALTIMORE ANNAPOLIS BLVD STE L, GLEN BURNIE, MD 21061-3278
(410) 999-6421
Mailing address
4940 EASTERN AVE, CLINICAL LABS, ROOM A102, JOHNS HOPKINS BAYVIEW MED CTR, BALTIMORE, MD 21224-2735
(410) 550-0648
(410) 550-2109
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
D0050680
MD
Other
Enumeration date
01/26/2007
Last updated
07/21/2022
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