Healthcare Provider Details

I. General information

NPI: 1710360110
Provider Name (Legal Business Name): JOHNS HOPKINS UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2015
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 EDGEWOOD ST
BALTIMORE MD
21216-2537
US

IV. Provider business mailing address

2000 EDGEWOOD ST
BALTIMORE MD
21216-2537
US

V. Phone/Fax

Practice location:
  • Phone: 410-291-2570
  • Fax: 410-233-5893
Mailing address:
  • Phone: 410-291-2570
  • Fax: 410-233-5893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATE CONNOR
Title or Position: MD
Credential:
Phone: 443-615-2132