Organization
AMBUSH LAB
Active
Parent organization
AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC
Authorized official
JACQUELINE EBONY AMBUSH DNP (OWNER)
(410) 707-5947
Entity
Organization
Contact information
Practice address
4367 HOLLINS FERRY RD STE 1C, BALTIMORE, MD 21227-3400
(410) 707-5947
(410) 707-5947
Mailing address
4367 HOLLINS FERRY RD STE 1C, BALTIMORE, MD 21227-3400
(410) 707-5947
(410) 707-5947
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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