Provider Demographics
NPI:1215901624
Name:JOHNSON, ERICA NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:NICOLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3915 ELAN CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-7313
Mailing Address - Country:US
Mailing Address - Phone:301-805-7718
Mailing Address - Fax:202-782-5183
Practice Address - Street 1:WALTER REED ARMY MEDICAL CENTER
Practice Address - Street 2:6900 GEORGIA AVE NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-1774
Practice Address - Fax:202-782-5183
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101238164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine