MEDICARE: DR. ANDREW JOHNSON D.C.

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
1	111N00000X	Chiropractor	S01814	MD

General Provider Information

NPI Number	:	1114939873
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JOHNSON D.C.

Provider Business Mailing Address
First Line	:	1126 N ROLLING RD
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-3826
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1126 N ROLLING RD
Second Line	:
City	:	CATONSVILLE
State	:	MD
Zip	:	21228-3826
Country	:	US
Telephone Number	:	410-744-1233
Fax Number	:	410-744-8649

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	11/30/2023

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