AMBUSH LAB – NPI #1295671311
Family Medicine

A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

Health Care Provider Taxonomy Code for Family Medicine

AMBUSH LAB is a provider located in BALTIMORE, MD. NPPES recently assigned the NPI number 1295671311 to AMBUSH LAB on April 29, 2026. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adolescent Medicine

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AMBUSH LAB below.

NPI Profile for
AMBUSH LAB

NPI Number
1295671311
Enumeration Date

(about 5 weeks ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AMBUSH LAB
Primary location
4367 HOLLINS FERRY RD STE 1C
BALTIMORE, MD 21227-3400
Phone: (410) 707-5947 Fax: (410) 707-5947
1 Other location(s):
5252 Hollister St Ste 203C
Houston, TX 77040-6214
Phone: (346) 678-4442
Fax: (346) 678-4442
Mailing address
Same as primary location
Organization Subpart
Yes - AMBUSH LAB is subpart of another organization.
Authorized Official
JACQUELINE AMBUSH
OWNER
Phone: (410) 707-5947
Updated
Certification Date
Apr 29, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0000X
- Family Medicine / Adolescent Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.