Healthcare Provider Details

I. General information

NPI: 1831919380
Provider Name (Legal Business Name): JOHNS HOPKINS COMMUNITY PHYSICIANS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2024
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 STEVENS FOREST RD STE 102107
COLUMBIA MD
21046-3231
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-720-7429
  • Fax: 410-720-7429
Mailing address:
  • Phone: 410-933-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN KRAVET
Title or Position: AO
Credential:
Phone: 410-735-4800