Healthcare Provider Details

I. General information

NPI: 1619348331
Provider Name (Legal Business Name): JOHNS HOPKINS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST SUITE 1112
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

601 N CAROLINE ST SUITE 1112
BALTIMORE MD
21287-0006
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-0015
  • Fax:
Mailing address:
  • Phone: 410-955-0015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number17823
License Number StateMD

VIII. Authorized Official

Name: JENNIFER L MILLAR
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 410-955-0015