Individual
SAMANTHA K EZOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13 WESTERN MARYLAND PKWY STE 104, HAGERSTOWN, MD 21740-6474
(301) 665-4575
(301) 665-4576
Mailing address
13 WESTERN MARYLAND PKWY STE 104, HAGERSTOWN, MD 21740-6474
(301) 665-4575
(301) 665-4576
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
PA
Other
Enumeration date
08/05/2019
Last updated
12/01/2021
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