Healthcare Provider Details

I. General information

NPI: 1922217470
Provider Name (Legal Business Name): MAYOR AND CITY COUNCIL OF BALTIMORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E FAYETTE ST
BALTIMORE MD
21202-4715
US

IV. Provider business mailing address

1515 E FAYETTE ST
BALTIMORE MD
21231-1432
US

V. Phone/Fax

Practice location:
  • Phone: 410-396-0353
  • Fax:
Mailing address:
  • Phone: 410-396-0353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number940239
License Number StateMD

VIII. Authorized Official

Name: TYRONE ALONZO CHAPMAN
Title or Position: MANAGER RCM
Credential:
Phone: 410-396-8000