Individual
MRS. JEUELLE M OTTLEY SAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7610 CARROLL AVE, SUITE 200, TAKOMA PARK, MD 20912-6384
(301) 891-2077
(301) 891-2080
Mailing address
6 PARK CENTER CT, STE 210, OWINGS MILLS, MD 21117-5604
(443) 953-8922
(855) 955-1334
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002743
MD
Other
Enumeration date
12/12/2006
Last updated
03/05/2021
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