Healthcare Provider Details

I. General information

NPI: 1699570465
Provider Name (Legal Business Name): BALTIMORE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 03/03/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 SMITH AVE STE 207
BALTIMORE MD
21209-1462
US

IV. Provider business mailing address

2530 SUMMERSON RD
BALTIMORE MD
21209-2549
US

V. Phone/Fax

Practice location:
  • Phone: 443-929-4853
  • Fax: 667-249-3995
Mailing address:
  • Phone: 443-929-4853
  • Fax: 667-249-3995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. YURY MALACHEVSKY
Title or Position: PRACTICE OWNER
Credential: DNP,CRNP,AGNP,PMHNP
Phone: 443-845-4458