Provider Demographics
NPI:1164584488
Name:JOHNS HOPKINS UNIVERSITY
Entity Type:Organization
Organization Name:JOHNS HOPKINS UNIVERSITY
Other - Org Name:JHM FACIAL, EYE & BODY PROSTHETICS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA CCA
Authorized Official - Phone:410-955-3213
Mailing Address - Street 1:1830 E MONUMENT ST
Mailing Address - Street 2:SUITE 7000
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0022
Mailing Address - Country:US
Mailing Address - Phone:410-955-3213
Mailing Address - Fax:410-955-1085
Practice Address - Street 1:1830 E MONUMENT ST
Practice Address - Street 2:SUITE 7000
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0022
Practice Address - Country:US
Practice Address - Phone:410-955-3213
Practice Address - Fax:410-955-1085
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNS HOPKINS UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-14
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0366380004Medicare NSC