Provider Demographics
NPI:1023266178
Name:MANUEL, MAURICIO ROJAS JR (PA-C)
Entity type:Individual
Prefix:MR
First Name:MAURICIO
Middle Name:ROJAS
Last Name:MANUEL
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:
Other - Last Name:MANUEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11350 MCCORMICK RD
Mailing Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21031-1002
Mailing Address - Country:US
Mailing Address - Phone:443-643-3000
Mailing Address - Fax:443-643-3001
Practice Address - Street 1:11350 MCCORMICK RD
Practice Address - Street 2:EXECUTIVE PLAZA 1, SUITE 501
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031-1002
Practice Address - Country:US
Practice Address - Phone:443-643-3000
Practice Address - Fax:443-643-3001
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDCOO02075363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical