Individual
GEORGE E WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 787-4000
Mailing address
PO BOX 64485, BALTIMORE, MD 21264-4485
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0041365
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2611916
AETNA HMO
—
01
—
38955
JOHNS HOPKINS HEALTHCARE
—
01
—
5229
BRAVO/ ELDER HEALTH
—
01
—
52352101
CAREFIRST BLUE CROSS
MD
01
—
5580400
CIGNA
—
01
—
7300115
AETNA PPO
—
05
—
99901600
—
MD
01
—
F551-0004
CAREFIRST BLUE CROSS
DC
Enumeration date
11/22/2005
Last updated
04/16/2008
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