Individual
ALEISHA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5424 DISCOVERY PARK BLVD., SUITE 109, WILLIAMSBURG, VA 23188-4430
(757) 707-3510
Mailing address
860 OMNI BLVD, SUITE 102, NEWPORT NEWS, VA 23606-4430
(757) 873-1935
(757) 223-7760
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101247439
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116017272
VA
Other
Enumeration date
06/08/2007
Last updated
12/05/2019
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