=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023218377
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FRANCIS JAY MUSSAI BM BCH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/24/2007
-----------------------------------------------------
Last Update Date | 07/24/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | PEDIATRIC ONCOLOGY JOHNS HOPKINS HOSPITAL CMSC 800, 600 N. WOLFE STREET
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21287-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-614-5055
-----------------------------------------------------
Fax | 410-955-0028
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PEDIATRIC ONCOLOGY JOHNS HOPKINS HOSPITAL CMSC 800, 600 N. WOLFE STREET
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21287-0001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-614-5055
-----------------------------------------------------
Fax | 410-955-0028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2080P0207X
-----------------------------------------------------
Taxonomy Name | Pediatric Hematology & Oncology Physician
-----------------------------------------------------
License Number | 22121
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------