| Associates In Family Practice Pa | |
|
12210 Plum Orchard Dr Suite 212 Silver Spring MD 20904-7800 | |
| (301) 622-6020 | |
| (301) 680-9335 |
| Full Name | Associates In Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 12210 Plum Orchard Dr, Silver Spring, Maryland |
| Authorized Official Name and Position | Adolph William Johnson (PRESIDENT) |
| Authorized Official Contact | 3016226020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Associates In Family Practice Pa 12210 Plum Orchard Dr Suite 212 Silver Spring MD 20904-7800 Ph: (301) 622-6020 | Associates In Family Practice Pa 12210 Plum Orchard Dr Suite 212 Silver Spring MD 20904-7800 Ph: (301) 622-6020 |
| NPI Number | 1376736603 |
|---|---|
| Provider Enumeration Date | 08/21/2007 |
| Last Update Date | 02/25/2013 |
| Medicare PECOS PAC ID | 2769375005 |
|---|---|
| Medicare Enrollment ID | O20040202001191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376736603 | NPI | - | NPPES |
| 0546781 | Other | MD | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Rena M Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447267661 PECOS PAC ID: 7012966500 Enrollment ID: I20050126000889 |
| Provider Name | Adolph William Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235139387 PECOS PAC ID: 9436042793 Enrollment ID: I20090320000412 |
| Provider Name | Prem Jayanthan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922425446 PECOS PAC ID: 8426323130 Enrollment ID: I20180905000237 |
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