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Individual

MARK STEPHEN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2154
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2154

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101248712
VA
208600000X
Surgery Physician
2015-00091
NC

Other

Enumeration date
08/14/2006
Last updated
09/24/2024
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