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General NPI Number Information
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NPI Number | 1699570465
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Entity Type | Organization
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Legal Business Name | BALTIMORE WELLNESS
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 2700 QUARRY LAKE DR STE 280
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City | BALTIMORE
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State | MD
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Zip | 21209-3769
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Country | US
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Telephone | 443-845-4458
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Fax |
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Provider Business Mailing Address
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Address Line | 2530 SUMMERSON RD
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City | BALTIMORE
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State | MD
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Zip | 21209-2549
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Country | US
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Telephone | 443-845-4458
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. YURY MALACHEVSKY
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Credential | DNP, MSN, CRNP
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Telephone | 443-845-4458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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