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Individual

JOI ADRIA JOHNSON-WEAVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
8615 RIDGELYS CHOICE DR, SUITE 105, BALTIMORE, MD 21236-3026
(410) 256-3200
Mailing address
PO BOX 418953, BOSTON, MA 02241-8953

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C10007760
DE
207Q00000X
Family Medicine Physician
Primary
D0068458
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1000038995
DE
05
790020100
MD
Enumeration date
09/28/2006
Last updated
11/08/2018
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