OrganizationActive
Ambush Lab
NPI 1295671311 · Adolescent Medicine (Family Medicine) Physician · Baltimore, MD
Provider details
- NPI number
- 1295671311
- Entity type
- Organization
- Primary specialty
- Adolescent Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Ambush Pediatrics and Family Medical Clinic
- Organization subpart
- Yes
- Authorized official
- Jacqueline Ambush, Owner(410) 707-5947
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(57/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4367 Hollins Ferry Rd Ste 1c
Baltimore, MD 21227-3400
Phone: (410) 707-5947
Fax: (410) 707-5947
Street-level locationGet directions
Mailing address
4367 Hollins Ferry Rd Ste 1c
Baltimore, MD 21227-3400
Additional practice locations (1)
- 5252 Hollister St Ste 203cHouston, TX 77040-6214Phone: (346) 678-4442Fax: (346) 678-4442
Registry dates
- Enumerated
- 2026-04-29
- Last updated
- 2026-04-29
- Certified
- 2026-04-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.