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General NPI Number Information
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NPI Number | 1871485342
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Entity Type | Individual
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Provider Name | DARIUS TIMOTHY JOHNSON
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Gender | Male
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 7615 WASHINGTON BLVD
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City | ELKRIDGE
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State | MD
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Zip | 21075-6443
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Country | US
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Telephone | 410-579-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 NORTHWIND RD
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City | PARKVILLE
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State | MD
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Zip | 21234-1252
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Country | US
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Telephone | 443-683-2666
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | A6104
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License Number State | MD
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