MEDICARE: JOHNS HOPKINS COMMUNITY PHYSICIANS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1649099193
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNS HOPKINS COMMUNITY PHYSICIANS

Provider Business Mailing Address
First Line	:	6201 GREENLEIGH AVE
Second Line	:
City	:	MIDDLE RIVER
State	:	MD
Zip	:	21220-2004
Country	:	US
Telephone Number	:	410-933-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	11085 LITTLE PATUXENT PKWY STE 103
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21044-2914
Country	:	US
Telephone Number	:	410-933-0000
Fax Number	:

Authorized Official
Title or Position	:	AO
Name	:	STEVEN KRAVET
Credential	:
Telephone Number	:	410-735-4800

Provider Enumeration Date	:	10/10/2024
Last Update Date	:	12/10/2024

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