Individual
MRS. SHAUNTAE MCLAMORE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASST CERTI
Contact information
Practice address
3675 J DEWEY GRAY CIR, SUITE 300, AUGUSTA, GA 30909-1868
(706) 863-9595
(888) 745-3917
Mailing address
PO BOX 3726, AUGUSTA, GA 30914-3726
(706) 863-9595
(888) 745-3917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
004154
GA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
04/30/2020
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