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Individual

DR. SHANEETA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
80 JESSE HILL JR DR SE, ATLANTA, GA 30303-3031
(404) 616-1000
Mailing address
720 WESTVIEW DRIVE SW, HARRIS BLDG., 100-A, ATLANTA, GA 30310
(404) 756-1400

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
068580
GA
208600000X
Surgery Physician
35091547
OH
208600000X
Surgery Physician
MD036166
DC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003132374A
GA
Enumeration date
11/04/2007
Last updated
01/27/2021
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