Healthcare Provider Details

I. General information

NPI: 1114458536
Provider Name (Legal Business Name): ZACHARIAH FODA M.D., PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2017
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST THE JOHNS HOPKINS HOSPITAL
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-1101
  • Fax: 410-550-7861
Mailing address:
  • Phone: 410-933-2704
  • Fax: 410-550-7861

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD92413
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberD0092413
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: