Provider Demographics
NPI:1336570456
Name:OHLAND, EMILY ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ROSE
Last Name:OHLAND
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:ROSE
Other - Last Name:ALMOG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:GASTRO CENTER OF MARYLAND
Mailing Address - Street 2:7120 MINSTREL WAY SUITE 100
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045
Mailing Address - Country:US
Mailing Address - Phone:410-290-6677
Mailing Address - Fax:410-290-6676
Practice Address - Street 1:GASTRO CENTER OF MARYLAND
Practice Address - Street 2:7120 MINSTREL WAY SUITE 100
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045
Practice Address - Country:US
Practice Address - Phone:410-290-6677
Practice Address - Fax:410-290-6676
Is Sole Proprietor?:No
Enumeration Date:2013-11-30
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA056633363A00000X
NJ25MP00319400363A00000X
MDC05292363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant