Provider Demographics
NPI:1023020872
Name:AFFRONTI, JOHN P (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:AFFRONTI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6201 GREENLEIGH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10803 FALLS ROAD
Practice Address - Street 2:PAVILLION III
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-4502
Practice Address - Country:US
Practice Address - Phone:410-616-7650
Practice Address - Fax:410-616-7651
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036119151207RG0100X
MDD0091561207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E64607Medicare UPIN