MEDICARE: ELMAN RETINA GROUP PA

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
1	207WX0108X	Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
2	207WX0107X	Retina Specialist (Ophthalmology) Physician

General Provider Information

NPI Number	:	1376414631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELMAN RETINA GROUP PA

Provider Business Mailing Address
First Line	:	9114 PHILADELPHIA RD STE 310
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21237-4350
Country	:	US
Telephone Number	:	410-686-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1838 GREENE TREE RD STE 170
Second Line	:
City	:	PIKESVILLE
State	:	MD
Zip	:	21208-7100
Country	:	US
Telephone Number	:	410-686-3000
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	ASHLEY MUNKER
Credential	:
Telephone Number	:	410-686-3000

Provider Enumeration Date	:	09/17/2025
Last Update Date	:	09/17/2025

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