Provider Demographics
NPI:1447804711
Name:BICKLEY, MARK (PHARMD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:BICKLEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8450 DORSEY RUN RD
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9486
Mailing Address - Country:US
Mailing Address - Phone:410-724-3000
Mailing Address - Fax:
Practice Address - Street 1:8450 DORSEY RUN RD
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9486
Practice Address - Country:US
Practice Address - Phone:410-724-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-25
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26851183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist