Individual
DR. LAURA ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
727 SE MAIN ST STE 320, SIMPSONVILLE, SC 29681-3249
(864) 454-6440
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33664
SC
208000000X
Pediatrics Physician
33664
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336648
—
SC
Enumeration date
06/15/2011
Last updated
05/23/2021
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