Individual
KOURTNEY ALISSA RICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
827 LINDEN AVE, BALTIMORE, MD 21201-4606
(410) 225-8790
(410) 225-8910
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-8040
(443) 462-3514
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D80044
MD
208M00000X
Hospitalist Physician
Primary
D80044
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2013
Last updated
12/14/2021
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