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Individual

RAY EDWARD JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
017835
GA
207RI0011X
Interventional Cardiology Physician
Primary
27647
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00222384A
GA
01
2089836
AETNA HMO
GA
01
237923
BCBS
GA
01
2671375-002
CIGNA
GA
01
4115000
AETNA PPO
GA
05
G17835
SC
Enumeration date
07/17/2006
Last updated
12/27/2023
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