Healthcare Provider Details

I. General information

NPI: 1922811017
Provider Name (Legal Business Name): MICHAEL EARLE CAMPBELL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2714 N CALVERT ST APT 2
BALTIMORE MD
21218-4873
US

IV. Provider business mailing address

2714 N CALVERT ST APT 2
BALTIMORE MD
21218-4873
US

V. Phone/Fax

Practice location:
  • Phone: 410-299-6037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number32536
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: