Healthcare Provider Details

I. General information

NPI: 1679715635
Provider Name (Legal Business Name): JORDAN MICHAEL SAX M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2009
Last Update Date: 12/20/2021
Certification Date: 12/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHNS HOPKINS UNIVERSITY DEPT OF EMERGENCY MED 1830 E. MONUMENT ST. STE 6-100
BALTIMORE MD
21287-0001
US

IV. Provider business mailing address

1830 E MONUMENT ST STE 6-100 JOHNS HOPKINS DEPARTMENT OF EMERGENCY MEDICINE
BALTIMORE MD
21287-0020
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-3380
  • Fax:
Mailing address:
  • Phone: 802-233-3069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0073870
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: