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Individual

DR. JISHA JOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
2304 WESVILL CT, STE 240, RALEIGH, NC 27607-2973
(919) 235-1802
(919) 235-1354
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
2020-03323
NC
207RI0200X
Infectious Disease Physician
35.125970
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1457680183
NC
Enumeration date
12/08/2009
Last updated
12/30/2024
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