Individual
SHAKEVIA V. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 BOSTON MEDICAL CENTER PLACE, BOSTON, MA 02118
(617) 414-5245
(617) 414-5520
Mailing address
801 ALBANY ST, FL G, BOSTON, MA 02119
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
24841
MS
2084P0800X
Psychiatry Physician
Primary
286906
MA
2084P0800X
Psychiatry Physician
55603
TN
2084P0802X
Addiction Psychiatry Physician
286906
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110171775A
—
MA
Enumeration date
05/03/2014
Last updated
02/15/2022
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