NPI 1093304669 · live from the CMS NPI Registry
Justin Ajose, PA-C
Physician Assistant, Medical in Essex, MD. National Provider Identifier 1093304669, active.
NPI record
| NPI | 1093304669 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 1354 Eastern Blvd, Essex, MD 21221 |
| Practice phone | 443-640-4524 |
| Mailing address | 2004 Rock Spring Rd., Forest Hill, MD 21050 |
| Enumerated | January 18, 2021 |
| Last updated | February 13, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | 1167981 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.