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Individual

CRYSTAL ANN GEMPKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
6701 N CHARLES ST, TOWSON, MD 21204-6881
(443) 849-2000
Mailing address
343 PONFIELD RD E, FOREST HILL, MD 21050-2537
(443) 617-5115

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0008377
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C0008377
STATE MEDICAL LICENSE
MD
Enumeration date
03/04/2022
Last updated
03/04/2022
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