Individual
AMY S. JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
305 10TH ST, SUITE 101, POCOMOKE, MD 21851-1607
(410) 957-3005
(410) 957-0550
Mailing address
305 10TH ST, SUITE 101, POCOMOKE, MD 21851-1607
(410) 957-3005
(410) 957-0550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0058928
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181482
PROVIDER NO.
MD
01
—
245973
PROVIDER NO.
VA
01
—
61721001
PROVIDER NO.
MD
01
—
877172
PROVIDER NO.
MD
01
—
F094 0007
PROVIDER NO.
MD
Enumeration date
04/06/2006
Last updated
07/09/2007
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