Individual
JUSTICE KIPLANGAT KOSKEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCHW
Contact information
Practice address
3001 S HANOVER ST # SA-155, BALTIMORE, MD 21225-1233
(410) 980-9889
(410) 350-8107
Mailing address
3001 S HANOVER ST # SA-155, BALTIMORE, MD 21225-1233
(410) 980-9889
(410) 350-8107
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275140097
CENTERS FOR MEDICARE & MEDICAID SERVICES
MD
Enumeration date
09/25/2020
Last updated
09/29/2020
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