Provider Demographics
NPI:1669439436
Name:COOL, ALICIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:ANN
Last Name:COOL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6701 N CHARLES ST
Mailing Address - Street 2:#5201
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6808
Mailing Address - Country:US
Mailing Address - Phone:410-339-5300
Mailing Address - Fax:410-339-7127
Practice Address - Street 1:6701 N CHARLES ST
Practice Address - Street 2:#5201
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-6808
Practice Address - Country:US
Practice Address - Phone:410-339-5300
Practice Address - Fax:410-339-7127
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-27
Last Update Date:2014-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD30717207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDB69093Medicare UPIN
MD596MMedicare PIN
B69093Medicare UPIN