Individual
DR. ANDREW EDWARD JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2101 W ARLINGTON BLVD STE 210, GREENVILLE, NC 27834-5758
(252) 931-7638
(252) 931-7694
Mailing address
PO BOX 30750, GREENVILLE, NC 27833-0750
(252) 931-7638
(252) 931-7694
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
28762
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255774014
BCBSNC
NC
05
—
1255774014
—
NC
Enumeration date
04/11/2013
Last updated
04/27/2022
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