Healthcare Provider Details

I. General information

NPI: 1285341628
Provider Name (Legal Business Name): ELIZABETH MARIA ARIAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1641 E JOPPA RD
TOWSON MD
21286-2105
US

IV. Provider business mailing address

7902 34TH ST
ROSEDALE MD
21237-1408
US

V. Phone/Fax

Practice location:
  • Phone: 443-275-1092
  • Fax:
Mailing address:
  • Phone: 410-842-7402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0008705
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: