=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518987700
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RHONDA MOORE JOHNSON M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/20/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 120 5TH AVE SUITE P4205
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15222-3000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-544-1027
-----------------------------------------------------
Fax | 412-544-2950
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 900 HIGHLANDER CIR
-----------------------------------------------------
City | WEXFORD
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15090-7463
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 724-935-9992
-----------------------------------------------------
Fax | 724-935-9997
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | MD066400L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------