Healthcare Provider Details

I. General information

NPI: 1669518965
Provider Name (Legal Business Name): CHRISTOPHER JORDAN GAMPER M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 02/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST JHOC 8
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

PO BOX 64474
BALTIMORE MD
21264-4474
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8751
  • Fax: 410-955-1002
Mailing address:
  • Phone: 410-614-5055
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberD0061508
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: