Provider Demographics
NPI:1780771030
Name:JOHNSON, CURTIS ANNON JR (MD)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:ANNON
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5875 ALLENTOWN RD.
Mailing Address - Street 2:
Mailing Address - City:SUITLAND
Mailing Address - State:MD
Mailing Address - Zip Code:20746
Mailing Address - Country:US
Mailing Address - Phone:301-702-2003
Mailing Address - Fax:973-678-3420
Practice Address - Street 1:5875 ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746
Practice Address - Country:US
Practice Address - Phone:301-702-2003
Practice Address - Fax:973-678-3420
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD89064208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
P381950OtherOXFORD
0011561OtherAETNA
0908194006OtherCIGNA
NJ1477102Medicaid
222496445OtherUNITED
73845OtherPHCS
83390OtherAMERIGROUP
01000078300OtherAMERICHOICE
1028545OtherNJ HORIZON
0068788OtherGHI
F02390OtherHEALTHNET