Individual
DR. SAMUEL ANDREW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 WHITCHER ST NE, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-1492
Mailing address
55 WHITCHER STREET, SUITE 460, MARIETTA, GA 30060-1155
(770) 427-7389
(770) 427-1492
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
54909
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003123548B
—
GA
05
—
003123548C
—
GA
05
—
003123548D
—
GA
05
—
003123548E
—
GA
05
—
003123548F
—
GA
05
—
003123548G
—
GA
05
—
003123548H
—
GA
05
—
003123548I
—
GA
05
—
003123548J
—
GA
05
—
003123548K
—
GA
05
—
003123548L
—
GA
05
—
003123548M
—
GA
05
—
003123548N
—
GA
05
—
003123548O
—
GA
05
—
003123548P
—
GA
05
—
003123548Q
—
GA
05
—
003123548R
—
GA
05
—
003123548S
—
GA
05
—
003123548T
—
GA
05
—
003123548U
—
GA
05
—
003123548V
—
GA
01
—
29879
MEDICAL LICENSE
SC
01
—
54909
MD
GA
Enumeration date
04/20/2007
Last updated
08/01/2019
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