Johnson, Mark Antonio

Johnson, Mark Antonio is an sole proprietor health care provider with primary practice located at 1140 Varnum Street Ne Suite 106, Washington DC 20017. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Johnson, Mark Antonio can be contacted via phone (202) 448-4014.

Contact Information

Primary practice address
1140 Varnum Street Ne Suite 106 Washington DC 20017
Phone: (202) 448-4014
Fax: (202) 448-4082
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD30469 District of Columbia

Profile Details

NPI number 1831118868
LBN Legal business name Johnson, Mark Antonio
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2006
Last updated Jul 19th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831118868 NPPES
Other 2063270 AETNA
Other 52821 AETNA
Other 16077 AETNA
MEDICAID 529000700 AETNA
MEDICAID 017148800 AETNA
Other 392560 AETNA
Other F7920001 AETNA

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