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General NPI Number Information
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NPI Number | 1578189650
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Entity Type | Individual
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Provider Name | EMILY ALAINE MARU PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 06/24/2020
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 810 BESTGATE RD STE 235
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3656
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Country | US
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Telephone | 443-231-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 10200 GRAND CENTRAL AVE STE 220
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City | OWINGS MILLS
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State | MD
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Zip | 21117-4366
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C08480
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License Number State | MD
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