Individual
DR. PETER MATHEW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1636 REGULUS AVE, COMNAVSPECWARDEVGRU, VIRGINIA BEACH, VA 23461-2200
(757) 893-2026
(757) 492-8409
Mailing address
1636 REGULUS AVE, COMNAVSPECWARDEVGRU, VIRGINIA BEACH, VA 23461-2200
(757) 893-2026
(757) 492-8409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101236742
VA
Other
Enumeration date
07/13/2007
Last updated
08/29/2012
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