Individual
GNANARAJ JOHNSON KOILPILLAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
194 THOMAS JOHNSON DR, SUITE A, FREDERICK, MD 21702-4679
(240) 215-6310
(240) 566-7751
Mailing address
PO BOX 37086, BALTIMORE, MD 21297-3086
(240) 439-8913
(240) 439-8910
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0057285
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
211841
MEDICARE PROVIDER #
MD
Enumeration date
01/03/2006
Last updated
07/30/2019
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