Individual
WAYNE T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5838 HARBOUR VIEW BLVD, SUITE 100, SUFFOLK, VA 23435-2663
(757) 673-5680
(757) 397-0236
Mailing address
5838 HARBOUR VIEW BLVD, SUITE 100, SUFFOLK, VA 23435-2663
(757) 673-5680
(757) 397-0236
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101040647
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006405223
—
VA
01
—
200028241
MEDICARE RR
VA
01
—
P00799588
RR MEDICARE
VA
Enumeration date
06/03/2006
Last updated
02/22/2011
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