Provider Demographics
NPI:1083714653
Name:BILLON, JOHN A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:A
Last Name:BILLON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1111 BENFIELD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-3002
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:443-679-1382
Practice Address - Street 1:1509 RITCHIE HWY
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2742
Practice Address - Country:US
Practice Address - Phone:410-757-7600
Practice Address - Fax:410-626-8043
Is Sole Proprietor?:No
Enumeration Date:2006-09-24
Last Update Date:2016-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD65013207Q00000X
DEC1-0008021207Q00000X
NJMA71829207Q00000X
NY229714-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD334815600Medicaid
MD153287ZDN3Medicare PIN
MD334815600Medicaid