Individual
MARK S. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2041 GEORGIA AVE NW # T3200, WASHINGTON, DC 20060
(202) 865-4440
(202) 865-3214
Mailing address
2041 GEORGIA NW AVE TOWER 6101, WASHINGTON, DC 20060-0001
(202) 865-6679
(202) 865-1617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA05722100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5128803
—
NJ
Enumeration date
09/28/2006
Last updated
11/08/2019
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