Healthcare Provider Details

I. General information

NPI: 1427194331
Provider Name (Legal Business Name): RACHEL LYN JOHNSON THORNTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHEL LYN JOHNSON M.D.

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE BSMT JOHNS HOPKINS BAYVIEW MEDICAL CENTER, PEDIATRICS DEPT
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

5200 EASTERN AVE STE 4200 MASON F. LORD BUILDING, CENTER TOWER
BALTIMORE MD
21224-2739
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0967
  • Fax: 410-550-1276
Mailing address:
  • Phone: 410-550-4226
  • Fax: 410-550-4153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP19043
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: