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NPI Code Detail

MEDICARE: ELMAN RETINA GROUP PA

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
1207WX0108XUveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
2207WX0107XRetina Specialist (Ophthalmology) Physician

General Provider Information

NPI Number : 1619840733
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 : 11055 LITTLE PATUXENT PKWY STE 105
Second Line :
City : COLUMBIA
State : MD
Zip : 21044-2908
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 : 09/25/2025
Last Update Date : 09/25/2025

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