Healthcare Provider Details

I. General information

NPI: 1609195320
Provider Name (Legal Business Name): JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 03/20/2024
Certification Date: 03/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10710 CHARTER DR STE 400
COLUMBIA MD
21044
US

IV. Provider business mailing address

PO BOX 412709
BOSTON MA
02241-2709
US

V. Phone/Fax

Practice location:
  • Phone: 443-276-9000
  • Fax: 443-276-9610
Mailing address:
  • Phone: 410-760-8840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTI MARTUCCI
Title or Position: JHRP BILLING MANAGER
Credential:
Phone: 410-760-8840