Provider Demographics
NPI:1275577439
Name:MORGAN-COOPER, ALICIA CELESTE (MD)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:CELESTE
Last Name:MORGAN-COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:
Other - Last Name:MUSGROVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1 E UNIVERSITY PKWY
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-2451
Mailing Address - Country:US
Mailing Address - Phone:410-235-1601
Mailing Address - Fax:410-467-6881
Practice Address - Street 1:1 E UNIVERSITY PKWY
Practice Address - Street 2:SUITE 109
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2451
Practice Address - Country:US
Practice Address - Phone:410-235-1601
Practice Address - Fax:410-467-6881
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0055808174400000X
MDD55808208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0055808OtherMD MEDICAL LICENSE NO.
MD204100600Medicaid
MDD0055808OtherMD MEDICAL LICENSE NO.