Edward John Wickman M.D.

NPI 1053305854 - Radiology - 2085R0202X

NPI Details
NPI 1053305854
Gender Male
Enumeration Date 09/07/2005
Last Updated 02/18/2011
Entity Type Individual
Active Over 11 years ago
Practice Location
1125 E SOUTHERN AVE
SUITE 300
MESA AZ, 85204-5045, US
Phone (480) 545-8119
Fax (480) 892-6805
Business Location
1125 E SOUTHERN AVE
SUITE 300
MESA AZ, 85204-5045, US
Phone (480) 545-8119
Fax (480) 892-6805
Toxanomy
Taxonomy Code 2085R0202X
License State Arizona
License Number 9919
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According to our database, Dr. Edward John Wickman M.D. NPI is 1053305854, taxonomy code is 2085R0202X and license number is 9919, license state is located at Arizona. Edward John Wickman M.D. physically located at 1125 E Southern Ave, Mesa AZ, 85204-5045. NPI Number Edward John Wickman M.D. has the Individual type.

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1053305854 NPI number is provided on an as is basis without warranty of any kind. 1053305854 is maintained by the National Plan & Provider Enumeration System. The contents of Edward John Wickman M.D. are for informational purposes only.