Individual
GLEN EDWARD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
716 MAIDEN CHOICE LN, SUITE 205, BALTIMORE, MD 21228-5943
(410) 788-7757
(470) 744-3817
Mailing address
716 MAIDEN CHOICE LANE, SUITE 205, BALTIMORE, MD 21228-5957
(410) 788-7757
(470) 744-3817
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D19558
MD
Other
Enumeration date
09/07/2005
Last updated
01/25/2017
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