Organization · Type 2 NPI
Ambush Pediatrics and Family Medical Clinic
Adolescent Medicine (Family Medicine) Physician · Halethorpe, MD
NPI number
1457956948
Active
Practice location
4367 Hollins Ferry Rd Ste 1C
Halethorpe, MD 21227-3400
Fax (410) 609-6672
Other practice locations
- 5252 Hollister St Ste 203C, Houston, TX 77040-6214 · (346) 678-4442
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adolescent Medicine (Family Medicine) Physician Primary | 207QA0000X | None listed |
| Health Service Clinic/Center | 261QH0100X | None listed |
Adolescent Medicine (Family Medicine) Physician: A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Another provider at this address
About NPI 1457956948
Ambush Pediatrics and Family Medical Clinic's National Provider Identifier is 1457956948, issued on Dec 2, 2020. The primary taxonomy on file is Adolescent Medicine (Family Medicine) Physician (207QA0000X), and the practice location is in Halethorpe, MD. The record was last updated on Apr 29, 2026.