MEDICARE: CHRISTINA JOHNS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	MD30446	DC
2	208000000X	Pediatrics Physician	D0056351	MD
3	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	MD30446	DC
4	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	D0056351	MD

General Provider Information

NPI Number	:	1740377720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA JOHNS MD

Provider Business Mailing Address
First Line	:	2301A FOREST DR
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3833
Country	:	US
Telephone Number	:	410-266-6767
Fax Number	:	410-266-6761

Provider Business Practice Location Address
First Line	:	2301A FOREST DR
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-3833
Country	:	US
Telephone Number	:	410-266-6767
Fax Number	:	410-266-6761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2006
Last Update Date	:	11/02/2021

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