Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | H89728 | MD |
Y | 213ES0000X | Sports Medicine | H89728 | MD |
NPI | 1467847939 |
---|---|
Provider Name | Alexis Coslick |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2015 |
Last Update Date | 18/08/2020 |