Organization
ROBERT M. RICKETTS, MD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MASON RICKETTS JR. M.D. (PHYSICIAN)
(410) 876-9111
Entity
Organization
Contact information
Practice address
910 WASHINGTON RD, SUITE E, WESTMINSTER, MD 21157-5827
(410) 876-9111
(410) 857-3345
Mailing address
910 WASHINGTON RD, SUITE E, WESTMINSTER, MD 21157-5827
(410) 876-9111
(410) 857-3345
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0039296
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2500754
UHC PROVIDER#
MD
01
—
2534363
AETNA PROV #
MD
01
—
596ARO
BC & BS MEMBER #
MD
01
—
629050
MAMSI/UHC PROVIDER#
MD
Enumeration date
07/08/2006
Last updated
04/20/2008
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