Individual
DR. SAMUEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5300 MEMORIAL DR, SUITE 112, STONE MOUNTAIN, GA 30083-3148
(678) 704-0306
Mailing address
5300 MEMORIAL DR, SUITE 112, STONE MOUNTAIN, GA 30083-3148
(678) 704-0306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
037841
GA
208600000X
Surgery Physician
037841
GA
208D00000X
General Practice Physician
037841
GA
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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