Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MDOO46258 | MD |
NPI | 1013123876 |
---|---|
Provider Name | Janet V Johnson |
First Address | Hyattsville, MD 20782-8148 |
Second Address | Hyattsville, MD 20782-8148 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 28/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
162011800 | (05) | MD |