Healthcare Provider Details

I. General information

NPI: 1922195734
Provider Name (Legal Business Name): DR. VIVIANA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VIVIANA CARRO MD

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NNMC 8901 WISCONSIN AVENUE
BETHESDA MD
20089
US

IV. Provider business mailing address

13116 ROSEBAY DR
GERMANTOWN MD
20874-3984
US

V. Phone/Fax

Practice location:
  • Phone: 301-319-4073
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberMD035350
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: