Healthcare Provider Details

I. General information

NPI: 1891148797
Provider Name (Legal Business Name): JOHNS HOPKINS UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 07/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

PO BOX 64252
BALTIMORE MD
21264-4252
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8662
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number
License Number StateMD

VIII. Authorized Official

Name: MICHAEL MULDERRIG
Title or Position: DIRECTOR A/R OPERATION
Credential:
Phone: 410-933-6247