Provider Demographics
NPI:1013199983
Name:JOHNS HOPKINS UNIVERSITY
Entity Type:Organization
Organization Name:JOHNS HOPKINS UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CHILD & ADOLESCENT PSYCHI
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:RIDDLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-955-2320
Mailing Address - Street 1:600 N WOLFE ST
Mailing Address - Street 2:CMSC 309
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0005
Mailing Address - Country:US
Mailing Address - Phone:410-955-7858
Mailing Address - Fax:410-955-8691
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:CMSC 309
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-7858
Practice Address - Fax:410-955-8691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDE15856283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
D77739Medicare UPIN