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Individual

DR. SPENCER FRY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4400 STAMP RD, SUITE 314, TEMPLE HILLS, MD 20748-6716
(301) 702-0047
(301) 702-0841
Mailing address
11703 AMER CT, FORT WASHINGTON, MD 20744-5953
(301) 282-8751

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
17232
DC
2084P0800X
Psychiatry Physician
Primary
D051645
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
011032300
DC
05
186100000
MD
Enumeration date
01/02/2007
Last updated
12/10/2012
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