Healthcare Provider Details

I. General information

NPI: 1619852738
Provider Name (Legal Business Name): GREATER BALTIMORE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6569 N CHARLES ST STE 705
BALTIMORE MD
21204-6832
US

IV. Provider business mailing address

6701 N CHARLES ST S CHAPMAN BLDG, STE 102
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 443-849-3838
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA CAMPBELL
Title or Position: INTERIM EVP/CFO
Credential:
Phone: 443-849-3844