Individual
RUTH ANGELICA NAOMI GAMBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6821 REISTERSTOWN RD LOWR LVL, BALTIMORE, MD 21215-1431
(410) 358-6450
Mailing address
4100 MADONNA RD, JARRETTSVILLE, MD 21084-1031
(484) 467-8211
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1170764
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1170764
NCCPA
MD
Enumeration date
02/08/2020
Last updated
11/04/2021
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