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Individual

MRS. MARY ELLEN EBERSOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10632 LITTLE PATUXENT PKWY STE 441, COLUMBIA, MD 21044-6260
(410) 720-4245
Mailing address
11038 MONTGOMERY RD, BELTSVILLE, MD 20705-2816
(301) 704-0882

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E01074
MD

Other

Enumeration date
08/03/2022
Last updated
08/03/2022
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