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Individual

DR. KELLY CHRISTINA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
21 CROSSROADS DR, SUITE 200, OWINGS MILLS, MD 21117-5441
(410) 581-8140
(410) 356-0885
Mailing address
25 CROSSROADS DR, SUITE 306, OWINGS MILLS, MD 21117-5421
(443) 738-2872
(443) 738-2713

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
25MA08567200
NJ
208800000X
Urology Physician
34470
SC
208800000X
Urology Physician
Primary
D0076185
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
254908500
MD
Enumeration date
02/19/2009
Last updated
08/22/2013
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