Individual
MS. AMANDA MARY JACKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
GREATER MARYLAND PAIN MANAGEMENT, 1130 ANNAPOLIS RD SUITE 100, ODENTON, MD 21113
(410) 672-2255
Mailing address
8700 SILVER KNOLL DR, PERRY HALL, MD 21128-9165
(410) 299-4359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0006512
MD
363A00000X
Physician Assistant
C06512
MD
Other
Enumeration date
07/10/2017
Last updated
10/24/2018
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