Basic Information
| Provider Information | |||||||||
| NPI: | 1396784336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TWANMOH | ||||||||
| FirstName: | JOSEPH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 110 S PACA ST | ||||||||
| Address2: | UNIV. OF MARYLAND EMERGENCY MED., 6TH FLOOR, SUITE 200 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011642 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103288025 | ||||||||
| FaxNumber: | 4103288028 | ||||||||
| Practice Location | |||||||||
| Address1: | 900 S. CATON AVE. | ||||||||
| Address2: | ST. AGNES HOSPITAL | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212295201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103682012 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 02/17/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/17/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD448245 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | D0046505 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 60050001 | 01 | MD | DC BLUE CROSS | OTHER | 60059303 | 01 | MD | BLUE CROSS | OTHER | 20047170 | 01 | MD | AMERIHEALTH MERCY HEALTH | OTHER | 338041600 | 05 | MD | MEDICAID |