Individual
CHARLES S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 19TH ST SE, HICKORY, NC 28602-4230
(828) 325-9849
(828) 325-9879
Mailing address
1072 X RAY DR STE B, GASTONIA, NC 28054-7488
(704) 671-1094
(704) 671-1095
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
200100712
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89136XW
—
NC
Enumeration date
08/11/2005
Last updated
06/23/2020
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