| Jhu - Psychiatry/phd's | |
|
600 N Wolfe St Baltimore MD 21287-0005 | |
| (410) 955-5129 | |
| Not Available |
| Full Name | Jhu - Psychiatry/phd's |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 600 N Wolfe St, Baltimore, Maryland |
| Authorized Official Name and Position | Shavonda L Keating (SR PRODUCTION UNIT MGR) |
| Authorized Official Contact | 4109336430 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jhu - Psychiatry/phd's Po Box 64260 Baltimore MD 21264-4260 Ph: () - | Jhu - Psychiatry/phd's 600 N Wolfe St Baltimore MD 21287-0005 Ph: (410) 955-5129 |
| NPI Number | 1881678878 |
|---|---|
| Provider Enumeration Date | 12/02/2005 |
| Last Update Date | 07/21/2022 |
| Certification Date | 03/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881678878 | NPI | - | NPPES |
| 161121600 | Medicaid | MD | |
| CD6088 | Other | MD | RRMC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Maryland) | Secondary |
| 103TC0700X | Psychologist - Clinical | (Maryland) | Primary |
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