Healthcare Provider Details

I. General information

NPI: 1952243487
Provider Name (Legal Business Name): PEARSON PRIMARY CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 RITCHIE HWY STE 206
SEVERNA PARK MD
21146-4137
US

IV. Provider business mailing address

844 RITCHIE HWY STE 206
SEVERNA PARK MD
21146-4137
US

V. Phone/Fax

Practice location:
  • Phone: 410-647-8829
  • Fax:
Mailing address:
  • Phone: 410-647-8829
  • Fax: 410-315-8444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLEGANT PEARSON
Title or Position: PHYSICIAN / OWNER
Credential: MD
Phone: 301-523-9862