Provider Demographics
NPI:1295232684
Name:JOHNSON, CHRISTOPHER GLENN II (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:GLENN
Last Name:JOHNSON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 K ST SE PH 19
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-0893
Mailing Address - Country:US
Mailing Address - Phone:202-735-1128
Mailing Address - Fax:346-205-0335
Practice Address - Street 1:22 M ST NE APT 415
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-6795
Practice Address - Country:US
Practice Address - Phone:202-735-1128
Practice Address - Fax:346-205-0335
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2023-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD93248207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine