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Individual

MS. CAROL A. JEROSIMICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
170 JENNIFER RD STE 240, ANNAPOLIS, MD 21401-7995
(410) 571-9000
(410) 266-1507
Mailing address
170 JENNIFER RD, STE 240, ANNAPOLIS, MD 21401-7995
(410) 571-9000
(410) 266-1507

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0001915
MD
363AS0400X
Surgical Physician Assistant
C0001915
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
487760200
FEDERAL WORKMANS COMP
Enumeration date
07/19/2005
Last updated
10/06/2020
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