Organization
SETON MEDICAL GROUP, INC
Active
Parent organization
ASCENSION HEALTH
Other names
Ascension Saint Agnes Primary Care Elkridge
Organization subpart
Yes
Provider details
NPI number
Legal business name
ASCENSION HEALTH
Authorized official
MR. WILLIAM B HIGGINBOTHAM (PRESIDENT/CEO)
(667) 234-3162
Entity
Organization
Contact information
Practice address
6518 MEADOWRIDGE RD STE 110, ELKRIDGE, MD 21075-6458
(667) 234-8650
Mailing address
6518 MEADOWRIDGE RD STE 110, ELKRIDGE, MD 21075-6458
(667) 234-8650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
10/17/2024
Last updated
10/31/2024
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