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Individual

DR. MARY ELLEN PADUSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4134 E JOPPA RD, SUITE 101, NOTTINGHAM, MD 21236-2284
(410) 256-1006
(410) 256-0088
Mailing address
110 BEACON POINT CT, JOPPA, MD 21085-4533
(410) 679-5922

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA0922
MD
152WC0802X
Corneal and Contact Management Optometrist
TA0922
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
210360-121
NVA
MD
01
50070
DAVIS VISION
MD
01
613064-02
CAREFIRST/ BLUE CROSS/BLU
MD
01
613064-03
CAREFIRST-BLUE CROSS BLUE SHIELD
MD
01
940691
EYEMED
MD
Enumeration date
10/14/2006
Last updated
10/21/2008
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