Individual
DR. DAVID E JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
Mailing address
PO BOX 927, 5 E. ALVON ROAD, SUITE 7, WHITE SULPHUR SPRINGS, WV 24986-2373
(304) 538-5030
(304) 536-5031
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101046138
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10022537
OPTIMA/SENTARA
VA
01
—
5937781
AETNA
VA
01
—
5937781
AETNA
—
05
—
7201681
—
VA
05
—
7239521
—
VA
Enumeration date
07/18/2006
Last updated
07/13/2022
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