Provider Demographics
NPI:1033315031
Name:MOTRAN, JOHNY J (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHNY
Middle Name:J
Last Name:MOTRAN
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 83849
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20883-3849
Mailing Address - Country:US
Mailing Address - Phone:301-699-5900
Mailing Address - Fax:301-699-9297
Practice Address - Street 1:6505 BELCREST RD STE 1
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2011
Practice Address - Country:US
Practice Address - Phone:301-699-5900
Practice Address - Fax:301-699-9297
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01450213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD6342390001Medicare NSC
MD170455ZFJ1Medicare PIN