Individual
PHILIP B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(843) 237-3378
(843) 237-5073
Mailing address
PO BOX 60968, CHARLOTTE, NC 28260-0968
(843) 237-3378
(843) 237-5073
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
200001391
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
128C2
BCBS
NC
05
—
89128C2
—
NC
01
—
930100123
RAILROAD
NC
05
—
Q0139E
—
SC
Enumeration date
04/14/2006
Last updated
03/17/2009
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