Individual
DR. NICOLE ELLYN LOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
22 S GREENE ST # N4WICU, BALTIMORE, MD 21201-1544
(410) 328-6716
(410) 706-5103
Mailing address
22 S GREENE ST # N4WICU, BALTIMORE, MD 21201-1544
(410) 328-6716
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0116034904
VA
208000000X
Pediatrics Physician
Primary
H0100583
MD
Other
Enumeration date
06/08/2018
Last updated
05/23/2024
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