NPI 1457956948 · live from the CMS NPI Registry
Ambush Pediatrics And Family Medical Clinic
Family Medicine, Adolescent Medicine in Halethorpe, MD. National Provider Identifier 1457956948, active.
NPI record
| NPI | 1457956948 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Family Medicine, Adolescent Medicine 207QA0000X |
| Practice location | 4367 Hollins Ferry Rd Ste 1c, Halethorpe, MD 21227 |
| Practice phone | 410-609-6677 |
| Enumerated | December 2, 2020 |
| Last updated | April 29, 2026 |
| Authorized official | Jacqueline Ambush, Owner/Operator |
| Other names | Ambush Pediatrics And Family Medical Clinic |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center, Health Services | 261QH0100X | — |
| Family Medicine, Adolescent Medicine primary | 207QA0000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.