Provider Demographics
NPI:1326081779
Name:MEYERHOFF, JOHN O (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:O
Last Name:MEYERHOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:ATTN: RHEUMATOLOGY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-8648
Mailing Address - Fax:410-601-4833
Practice Address - Street 1:2411 W BELVEDERE AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5228
Practice Address - Country:US
Practice Address - Phone:410-601-8648
Practice Address - Fax:410-601-4833
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD22157207R00000X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD794371700Medicaid
MD10054028OtherR/R MEDICARE PROVIDER #
MDK939GT47Medicare PIN
MD10054028OtherR/R MEDICARE PROVIDER #