Healthcare Provider Details

I. General information

NPI: 1598588014
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 N CHARLES ST STE 306
BALTIMORE MD
21204-5804
US

IV. Provider business mailing address

6701 N CHARLES STREET SOUTH CHAPMAN BUILDING, SUITE 102
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-4000
  • Fax:
Mailing address:
  • Phone: 443-849-2435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CAMPBELL
Title or Position: INTERIM EVP & CFO
Credential:
Phone: 443-849-3844