Individual
ELLEN MARIE M MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2401 W BELVEDERE AVE, BALTIMORE, MD 21215-5216
(410) 736-0250
Mailing address
758 S MACON ST, BALTIMORE, MD 21224-2640
(410) 736-0250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0008185
MD
Other
Enumeration date
10/04/2021
Last updated
10/04/2021
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