Provider Demographics
NPI:1215113972
Name:JOHNSON, DANIEL HICKS (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HICKS
Last Name:JOHNSON
Suffix:
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 1:5601 FISHERS LN RM 9E39
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1792
Mailing Address - Country:US
Mailing Address - Phone:240-627-3066
Mailing Address - Fax:
Practice Address - Street 1:5601 FISHERS LN RM 9E39
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1792
Practice Address - Country:US
Practice Address - Phone:240-627-3066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-11
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0076748207R00000X, 207RI0200X
DCMD042465207R00000X, 207RI0200X
MDD76748208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease