Individual
RICHARD D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 W 27TH ST, LUMBERTON, NC 28358-3075
(910) 671-5000
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
0093-00163
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130XP
BLUE CROSS BLUE SHIELD
NC
05
—
89130XP
—
NC
Enumeration date
05/10/2006
Last updated
06/29/2021
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