Healthcare Provider Details

I. General information

NPI: 1376537456
Provider Name (Legal Business Name): JOHNS HOPKINS UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2005
Last Update Date: 07/21/2022
Certification Date: 03/08/2021
Deactivation Date: 02/22/2008
Reactivation Date: 03/11/2008

III. Provider practice location address

600 N WOLFE STREET
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

PO BOX 64264
BALTIMORE MD
21264-4264
US

V. Phone/Fax

Practice location:
  • Phone: 410-558-5218
  • Fax:
Mailing address:
  • Phone: 410-933-4397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateMD

VIII. Authorized Official

Name: SHAVONDA L KEATING
Title or Position: SR PRODUCTION UNIT MGR
Credential:
Phone: 410-933-6430