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Individual

YVETTE C. JOHNSON-THREAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1510 N 28TH ST, SUITE 308, RICHMOND, VA 23223-5311
(804) 644-1665
(804) 644-5285
Mailing address
1510 N 28TH ST, SUITE 308, RICHMOND, VA 23223-5311
(804) 644-1665
(804) 644-5285

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101054237
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010023921
VA
01
2104493
MAMSI
VA
01
212408
SOUTHERN HEALTH SERVICES
VA
01
463643
ANTHEM BCBS OF VA
VA
01
5487309
AETNA LIFE
VA
01
6246708
CIGNA
VA
01
65960
SENTARA
VA
01
P00153281
RAILROAD MEDICARE
VA
Enumeration date
07/06/2006
Last updated
11/25/2009
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