Healthcare Provider Details
I. General information
NPI: 1467639260
Provider Name (Legal Business Name): JOHNS HOPKINS COMMUNITY PHYSICIANS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/24/2008
Last Update Date: 12/10/2024
Certification Date: 12/10/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 E EAGER ST
BALTIMORE MD
21202-5533
US
IV. Provider business mailing address
3100 WYMAN PARK DR SUITE 359A
BALTIMORE MD
21211-2803
US
V. Phone/Fax
- Phone: 410-522-9800
- Fax:
- Phone: 410-338-3016
- Fax: 410-338-3420
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BARBARA
G.
COOK
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-735-4800