Healthcare Provider Details

I. General information

NPI: 1710817846
Provider Name (Legal Business Name): SHELUMIEL CHANNIEL JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 W LOMBARD ST # 7050
BALTIMORE MD
21201-1512
US

IV. Provider business mailing address

3850 BOSTON ST APT 7050
BALTIMORE MD
21224-5786
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-0501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0001342317
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: