Healthcare Provider Details

I. General information

NPI: 1336570456
Provider Name (Legal Business Name): EMILY ROSE OHLAND PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY ROSE ALMOG PA-C

II. Dates (important events)

Enumeration Date: 11/30/2013
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GASTRO CENTER OF MARYLAND 7120 MINSTREL WAY SUITE 100
COLUMBIA MD
21045
US

IV. Provider business mailing address

GASTRO CENTER OF MARYLAND 7120 MINSTREL WAY SUITE 100
COLUMBIA MD
21045
US

V. Phone/Fax

Practice location:
  • Phone: 410-290-6677
  • Fax: 410-290-6676
Mailing address:
  • Phone: 410-290-6677
  • Fax: 410-290-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA056633
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number25MP00319400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC05292
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: