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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | Ashley Willis | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| Description | License No: D63773 | [sources] | |||
| First name | Ashley | [sources] | |||
| Last name | Willis | [sources] | |||
| NPI | 1346337060 | [sources] | |||
| Sector | MD | [sources] | |||
| Address | 5010 YORK ROAD, Baltimore MD 21212 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in Maryland's Medicaid program.
United States of America · MDH
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Maryland Department of Health | - | |||