| Ascension Saint Agnes Primary Care Ellicott City | |
|
2850 North Ridge Road Suite 103 Ellicott City MD 21043-3396 | |
| (410) 465-8119 | |
| Not Available |
| Full Name | Ascension Saint Agnes Primary Care Ellicott City |
|---|---|
| Speciality | Family Medicine |
| Location | 2850 North Ridge Road, Ellicott City, Maryland |
| Authorized Official Name and Position | William B Higginbotham (PRESIDENT/CEO) |
| Authorized Official Contact | 6672343162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Saint Agnes Primary Care Ellicott City 2850 North Ridge Road Suite 103 Ellicott City MD 21043-3396 Ph: (410) 465-8119 | Ascension Saint Agnes Primary Care Ellicott City 2850 North Ridge Road Suite 103 Ellicott City MD 21043-3396 Ph: (410) 465-8119 |
| NPI Number | 1518787142 |
|---|---|
| Provider Enumeration Date | 10/17/2024 |
| Last Update Date | 10/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518787142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
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