Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 30759 | DC |
NPI | 1114926565 |
---|---|
Provider Name | Lynt Johnson |
First Address | Washington, DC 20037-1888 |
Second Address | Washington, DC 20037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 24/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B98174 | (02) |