Individual
PETER JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C, PA-C
Contact information
Practice address
1009 WOODSHIRE LN, STREET, MD 21154-1115
(410) 452-5599
Mailing address
1009 WOODSHIRE LN, STREET, MD 21154-1115
(410) 452-5599
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0000466
MD
367H00000X
Anesthesiologist Assistant
Primary
—
—
Other
Enumeration date
06/15/2006
Last updated
08/19/2010
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