Provider Demographics
NPI:1275180424
Name:JOHNS HOPKINS UNIVERSITY
Entity Type:Organization
Organization Name:JOHNS HOPKINS UNIVERSITY
Other - Org Name:JHU - PHYSICAL MEDICINE & REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR PRODUCTION UNIT MGR
Authorized Official - Prefix:
Authorized Official - First Name:SHAVONDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:KEATING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-933-6430
Mailing Address - Street 1:PO BOX 64407
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4407
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-955-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOHNS HOPKINS UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-22
Last Update Date:2021-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty