Individual
DR. BURT POWERS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2023 S 17TH ST, WILMINGTON, NC 28401-6600
(910) 251-6499
(910) 251-6511
Mailing address
1009 CREEKSIDE LN, WILMINGTON, NC 28411-7656
(910) 681-1161
(910) 251-6511
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
20408
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136KH
BLUE CROSS NORTH CAROLINA
NC
05
—
89136KH
—
NC
Enumeration date
11/29/2006
Last updated
07/08/2007
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