Healthcare Provider Details

I. General information

NPI: 1417422932
Provider Name (Legal Business Name): JOHNS HOPKINS COMMUNITY PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2018
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR # 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-9800
  • Fax:
Mailing address:
  • Phone: 410-933-5412
  • Fax: 410-933-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN KRAVET
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 410-735-4800