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NPI Code Detail

MEDICARE: EMILY C BAGBY PA-C

MEDICARE: EMILY C BAGBY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantC0003634MD

General Provider Information

NPI Number : 1720277270
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY C BAGBY PA-C
Provider Business Mailing Address
First Line : 2415 MUSGROVE RD STE 105
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-5224
Country : US
Telephone Number : 301-989-0193
Fax Number : 301-879-2325
Provider Business Practice Location Address
First Line : 2415 MUSGROVE RD STE 105
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-5224
Country : US
Telephone Number : 301-989-0193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/22/2007
Last Update Date : 03/12/2026

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Directions to “ EMILY C BAGBY PA-C” Practice Location

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