Provider Demographics
NPI:1588284392
Name:CLOUGH, JOANNA M (DO)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:M
Last Name:CLOUGH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:O
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8501 ARLINGTON BLVD STE 300
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4625
Practice Address - Country:US
Practice Address - Phone:703-560-1611
Practice Address - Fax:703-573-0217
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-22
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
VA0102208419207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program