MEDICARE: JUSPEN ENTERPRISES INCORPORTATED

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	2084P0800X	Psychiatry Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154488013
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUSPEN ENTERPRISES INCORPORTATED

Provider Business Mailing Address
First Line	:	11703 AMER CT
Second Line	:
City	:	FORT WASHINGTON
State	:	MD
Zip	:	20744-5953
Country	:	US
Telephone Number	:	301-292-8751
Fax Number	:

Provider Business Practice Location Address
First Line	:	4400 STAMP RD
Second Line	:	SUITE 314
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-6716
Country	:	US
Telephone Number	:	301-702-0047
Fax Number	:	301-702-0841

Authorized Official
Title or Position	:	CEO
Name	:	DR. SPENCER F JOHNSON
Credential	:	M.D.
Telephone Number	:	301-706-5358

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	05/14/2008

Similar Medicare Providers

1063579779 — DR. SPENCER FRY JOHNSON M.D.
Practice Location Address:

4400 STAMP RD , SUITE 314
TEMPLE HILLS, MD
20748-6716

Practice Phone: 301-702-0047
Practice Fax: 301-702-0841

1114040938 — DR. OBADIAH J PETERS D.D.S.
Practice Location Address:

4400 STAMP RD , SUITE 202
TEMPLE HILLS, MD
20748-6716

Practice Phone: 301-316-1236
Practice Fax: 301-316-1237

1326211202 — TIFFANY ROYSTER LCPC
Practice Location Address:

4400 STAMP RD
TEMPLE HILLS, MD
20748-6716

Practice Phone: 301-775-3765
Practice Fax: 301-248-4338

1871720391 — SUNSHINE ON THE GO NURSING, INC.
Practice Location Address:

4400 STAMP RD , SUITE 308
TEMPLE HILLS, MD
20748-6716

Practice Phone: 240-695-1772
Practice Fax: 240-695-1888

1467862771 — MARYLAND FAMILY DENTISTRY ASSOCIATES
Practice Location Address:

4400 STAMP RD , 201
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Practice Fax:

1487707535 — SANDRA LEE BARRETT LCSW-C
Practice Location Address:

4400 STAMP RD , 306
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