Provider Demographics
NPI:1609677723
Name:NISHIKAWA, JAVIER KENICHI (MD)
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:KENICHI
Last Name:NISHIKAWA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 S EUTAW ST STE 500
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1619
Mailing Address - Country:US
Mailing Address - Phone:410-328-2477
Mailing Address - Fax:
Practice Address - Street 1:16 S EUTAW ST STE 500
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1619
Practice Address - Country:US
Practice Address - Phone:256-520-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program