Individual
JUSTIN AJOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1354 EASTERN BLVD, ESSEX, MD 21221-3423
(443) 640-4524
Mailing address
2004 ROCK SPRING RD., FOREST HILL, MD 21050-2310
(444) 640-4524
(443) 567-5574
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1167981
MD
Other
Enumeration date
01/18/2021
Last updated
02/13/2021
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