Cknmg

NPI #1154281251 in Baltimore, Maryland

Provider Information

NPI Number: 1154281251
Entity Type: Organization
Organization Name: Cknmg
Primary Specialty: Family Medicine
Enumeration Date: Nov 12, 2025
Last Updated: Jan 20, 2026

Practice Location

Address: 1501 S CLINTON ST
City: Baltimore
State: Maryland
ZIP Code: 21224-5730
Phone: (866) 233-6925

Authorized Official

Name: MARY JANE FAVAZZA
Title: CEO
Phone: (410) 205-1487

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Pediatrics	208000000X
Family Medicine	207Q00000X	Primary

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