Provider Demographics
NPI:1518987700
Name:JOHNSON, RHONDA MOORE (MD)
Entity Type:Individual
Prefix:DR
First Name:RHONDA
Middle Name:MOORE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 HIGHLANDER CIR
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-7463
Mailing Address - Country:US
Mailing Address - Phone:724-935-9992
Mailing Address - Fax:724-935-9997
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:SUITE P4205
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-544-1027
Practice Address - Fax:412-544-2950
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD066400L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0723659Medicaid
OHD98004Medicare UPIN