Healthcare Provider Details

I. General information

NPI: 1871353508
Provider Name (Legal Business Name): JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

205 CENTER ST STE 100
MOUNT AIRY MD
21771-5498
US

IV. Provider business mailing address

PO BOX 412709
BOSTON MA
02241-2709
US

V. Phone/Fax

Practice location:
  • Phone: 410-760-8840
  • Fax: 410-367-2464
Mailing address:
  • Phone: 410-760-8840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

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