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NPI Code Detail

MEDICARE: DR. JENNY ANNE JOHN MD

MEDICARE: DR. JENNY ANNE JOHN 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
1207R00000XInternal Medicine PhysicianD0055275MD

General Provider Information

NPI Number : 1023195518
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNY ANNE JOHN MD
Provider Business Mailing Address
First Line : 2101 EAST JEFFERSON STREET
Second Line : PPQA MEDICARE COMPLIANCE UNIT 6 WEST
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-6660
Fax Number : 301-816-6308
Provider Business Practice Location Address
First Line : 6104 OLD BRANCH AVENUE
Second Line :
City : TEMPLE HILLS
State : MD
Zip : 20748-2518
Country : US
Telephone Number : 301-702-6100
Fax Number : 301-702-6366
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 06/23/2021

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