# DOMINIC A JOHNSON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1952314353
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207PE0004X | Emergency Medical Services (Emergency Medicine) Physician | 0101049402 | VA | Yes |

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 07/08/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0633R | BLUE CROSS BLUE SHIELD NC | — |
| 01 | — | 082480 | BLUE CROSS BLUE SHIELD VA | — |
| 01 | — | 251490 | MAMSI/MDIPA | — |
| 01 | — | 27936 | OPTIMA | — |
| 01 | — | 3900570 | OPTIMUM CHOICE | — |
| 01 | — | 790633R | MEDICAID | NC |