MEDICARE: ADOLPH WILLIAM JOHNSON JR. M.D.

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	207Q00000X	Family Medicine Physician	D0033109	MD

General Provider Information

NPI Number	:	1235139387
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADOLPH WILLIAM JOHNSON JR. M.D.

Provider Business Mailing Address
First Line	:	12501 PROSPERITY DR STE 410
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1652
Country	:	US
Telephone Number	:	301-368-0038
Fax Number	:	301-328-0006

Provider Business Practice Location Address
First Line	:	12501 PROSPERITY DR STE 410
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20904-1652
Country	:	US
Telephone Number	:	301-368-0038
Fax Number	:	301-328-0006

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	12/15/2025

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