Provider Demographics
NPI:1992728380
Name:UZICANIN, ERNEST (MD)
Entity type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:
Last Name:UZICANIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19236 MEADOW VIEW DR
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-2924
Mailing Address - Country:US
Mailing Address - Phone:301-745-3695
Mailing Address - Fax:301-745-4572
Practice Address - Street 1:19236 MEADOW VIEW DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2924
Practice Address - Country:US
Practice Address - Phone:301-745-3695
Practice Address - Fax:301-745-4572
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040622207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
68550001OtherFEDERAL BCBS NASCO
080103436OtherRAILROAD MEDICARE
MD0U04OtherBCBS
F29003Medicare UPIN
MD359QMedicare ID - Type Unspecified